Nystagmus: an uncommon neurological manifestation of thiamine deficiency as a serious complication of sleeve gastrectomy. 
Wernicke encephalopathy--a debilitating acute or subacute neurological disorder-is caused by a deficiency in thiamine (vitamin B(1)).  It is characterized by a classical clinical triad of symptoms: ocular impairment, cerebellar dysfunction, and confusion.  Although bariatric surgery can certainly improve the overall health of an obese individual, it can also make him or her more susceptible to serious nutrition deficiencies.  Following surgery, inadequate caloric intake, rapid and excessive weight loss, food intolerance, lack of adherence to nutrition supplementation, and/or the onset of prolonged vomiting can lead to severe nutrition deficiencies.  It is generally believed that the more malabsorptive the surgery proves, the more likely is it that such a deficiency will occur.  The case presented here shows that after sleeve gastrectomy (SG), a patient may also develop dangerous nutrition deficits that can negatively affect his or her life.  In this particular case, a patient presented with a severe vitamin B(1) deficiency following SG for morbid obesity.  Although patients may exhibit pathophysiologies similar to Wernicke encephalopathy after this surgery, only 2 cases of severe vitamin B(1) deficiency following sleeve gastrectomy have been reported.  The grave consequences of thiamine deficiency observed in this patient underscore the importance of supplementation after SG.