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Cohen Vig L, Straussberg R, Ziv N, Hirschfeld-Dicker L, Konen O, Aharoni S. Neurologic complications of thiamine (B1) deficiency following bariatric surgery in adolescents. Eur J Paediatr Neurol 2024; 50:74-80. [PMID: 38705013 DOI: 10.1016/j.ejpn.2024.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 04/07/2024] [Accepted: 04/17/2024] [Indexed: 05/07/2024]
Abstract
BACKGROUND The prevalence of obesity among children and adolescents is rising and poses a major health concern. Bariatric surgery is well established in adults and has become an option for adolescents. Thiamine (B1) deficiency is common following bariatric surgery in adults. It may present as Beri-Beri, Wernicke encephalopathy, or Korsakoff psychosis. OBJECTIVE Our aim was to describe the clinical features, diagnosis, and treatment of adolescents who presented with B1 deficiency after bariatric surgery at one center, and to summarize the data from the literature. PATIENTS Three adolescents with morbid obesity (two boys and one girl, aged 15.5 to- 17-years-old), presented at Schneider Children's Medical Center of Israel with progressive lower limb pain and weakness 2-3 month following a bariatric procedure (sleeve gastrectomy or narrowing of a bariatric band). The girl also had upper limb involvement and cerebellar signs. All three were non-compliant with micronutrient supplementation. After admission, they received intravenous B1 and oral multivitamin supplementation, and their symptoms improved considerably. CONCLUSIONS Micronutrient supplementation following bariatric surgery is crucial to prevent deficiencies. In adolescents, compliance with micronutrient supplementation should be assessed before and after such surgery. Thiamine deficiency may cause polyneuropathy, among other symptoms. Treatment reduces the severity of neurological complications.
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Affiliation(s)
- Lital Cohen Vig
- Institute of Pediatric Neurology, Schneider Children's Medical Center of Israel, Petach Tikva, Israel; Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel.
| | - Rachel Straussberg
- Institute of Pediatric Neurology, Schneider Children's Medical Center of Israel, Petach Tikva, Israel; Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Noa Ziv
- Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel; Pediatric Department C, Schneider Children's Medical Center of Israel, Petach Tikva, Israel
| | - Lior Hirschfeld-Dicker
- Pediatric Department C, Schneider Children's Medical Center of Israel, Petach Tikva, Israel
| | - Osnat Konen
- Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel; Institute of Pediatric Radiology, Schneider Children's Medical Center of Israel, Petach Tikva, Israel
| | - Sharon Aharoni
- Institute of Pediatric Neurology, Schneider Children's Medical Center of Israel, Petach Tikva, Israel; Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel
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Avital D, Peretz S, Perlow E, Konen O, Inbar E, Bulkowstein Y, Nahum E, Aharoni S, Vig LC, Nevo Y, Auriel E, Straussberg R. Clinical improvement of a toddler with COVID-19 focal cerebral arteriopathy possibly due to intra-arterial nimodipine. Eur J Paediatr Neurol 2022; 40:40-43. [PMID: 35933829 PMCID: PMC9339169 DOI: 10.1016/j.ejpn.2022.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 06/24/2022] [Accepted: 07/21/2022] [Indexed: 11/30/2022]
Abstract
Pediatric stroke is considered an infrequent complication of COVID-19. Focal cerebral arteriopathy (FCA) is one of the most common causes of arterial ischemic stroke in a previously healthy child. The present report describes a toddler with FCA most likely induced by SARS-CoV-2 infection who showed significant clinical improvement that may be related to injection of intra-arterial nimodipine. To our knowledge, this is the first reported use of nimodipine in this setting.
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Affiliation(s)
- Dekel Avital
- Department of Pediatric Neurology, Schneider Children's Medical Center of Israel, Petach Tikva, Israel; Faculty of Health Science, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Shlomi Peretz
- Department of Neurology, Rabin Medical Center - Beilinson Hospital, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Eliauh Perlow
- Unit of Interventional Neuroadiology, Department of Imaging, Rabin Medical Center - Beilinson Hospital, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Osnat Konen
- Radiology Department, Schneider Children's Medical Center of Israel, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Edna Inbar
- Radiology Department, Rabin Medical Center - Beilinson Hospital, Petach Tikv, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yarden Bulkowstein
- Department of Pediatrics B, Schneider Children's Medical Center of Israel, Petach Tikva, Israel
| | - Elhanan Nahum
- Pediatric Intensive Care Unit, Schneider Children's Medical Center of Israel, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Sharon Aharoni
- Department of Pediatric Neurology, Schneider Children's Medical Center of Israel, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Lital Cohen Vig
- Department of Pediatric Neurology, Schneider Children's Medical Center of Israel, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yoram Nevo
- Department of Pediatric Neurology, Schneider Children's Medical Center of Israel, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Eitan Auriel
- Department of Neurology, Rabin Medical Center - Beilinson Hospital, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Rachel Straussberg
- Head Neurogenetic Service, Department of Pediatric Neurology, Schneider Children's Medical Center of Israel, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
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Sagi-Dain L, Cohen Vig L, Kahana S, Yacobson S, Tenne T, Agmon-Fishman I, Klein C, Matar R, Basel-Salmon L, Maya I. Chromosomal microarray vs. NIPS: analysis of 5541 low-risk pregnancies. Genet Med 2019; 21:2462-2467. [DOI: 10.1038/s41436-019-0550-x] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Accepted: 05/10/2019] [Indexed: 12/18/2022] Open
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