Abstracts

Rationale: The rates of gastric bypass procedures have been increasing in the United States due to the increasing prevalence of obesity. Because of this, in recent years, neurologic complications associated with the surgery have been described. These include encephalopathy, myelopathy, and neuropathy. These complications have been felt to be related to nutritional abnormalities. Seizures and epilepsy have been considered as a potential complication, but have not yet been described. Our goal was to determine if there was an increased post-operative incidence of epilepsy, seizures, or abnormal spells in patients who had undergone Roux-en-Y Gastric Bypass surgery at the Mayo Clinic in Arizona (MCA). Methods: After IRB approval was obtained, we compiled a general list of specific diagnoses that were commonly used within the epilepsy division at MCA to identify seizures, epilepsy, or atypical spells. We then conducted a search of the database involving all patients having undergone Roux-en-Y Gastric Bypass (N=608) at Mayo Clinic in Arizona between 2001 and 2010 for the ICD-9 codes of interest. Independent chart review of those patients who had received the diagnoses of interest was then conducted to get a detailed history regarding that diagnosis. Results: Two patients out of 608 had a diagnosis involving one of the nine ICD-9 codes we identified of interest. Both of these patients had a previous diagnosis of seizures prior to their surgery, and chart review of follow-up visits indicated no exacerbation of previously existing seizure disorder. There were no new diagnoses of epilepsy, seizures, or spells in follow up of the post-operative patients over a period of two years. Conclusions: There was no apparent increase in the incidence of epilepsy, seizures, and/or spells after Roux-en-Y Gastric Bypass. In addition, Roux-en-Ydid not exacerbate pre-existing seizure disorders. Close post-operative follow up to ensure that nutritional and metabolic abnormalities do not occur is beneficial in this vulnerable population. With an appropriate Bariatric Surgery program, the risk of developing epilepsy is not elevated.