Encéphalopathie de Wernicke après sleeve gastrectomie :Un diagnostic ophtalmologique vital

We report the Wernicke's encephalopathy (WE) case of a 19-year-old woman who had a sleeve gastrectomy 2 months before and came with complaints of acute bilateral vision loss, diplopia, photophobia and walking difficulty. She had vomiting for a week and had no vitamin supplementation since her surgery. The ophthalmological examination showed vertical nystagmus in all gaze position, impaired abduction on the left eye (left sixth nerve palsy) and best-corrected distance visual acuity < 1/20 on both eyes. Eye fundus showed papillary and retinal hemorrhages. Cerebral imaging was normal. This clinical pictures in a context of bariatric surgery made us suspect a Wernicke's encephalopathy and treatment with thiamine supplementation was started. Improvement started within a few days and after a few months following the treatment initiation almost all the symptoms had disappeared. It is important to diagnose the disease early because it can lead to severe neurological damage or death. The diagnosis is clinical but uneasy because of the multiplicity of presentations. Thiamine supplementation must be started immediately in case of WE suspicion. Definitive diagnosis will be confirmed by rapid improvement of the clinical picture together and by the results of blood thiamine.SCOPUS: ar.jDecretOANoAutActif