Bariatric surgery related proximal myopathy: A partially reversible complication

M Brisset; M C Durand; A Iosif; M Hanachi; C Palazzo; R-Y Carlier; P Laforêt; G Nicolas

doi:10.1016/j.neurol.2020.10.012

Bariatric surgery related proximal myopathy: A partially reversible complication

Rev Neurol (Paris). 2021 Nov;177(9):1183-1188. doi: 10.1016/j.neurol.2020.10.012. Epub 2021 Feb 25.

Authors

M Brisset¹, M C Durand², A Iosif³, M Hanachi⁴, C Palazzo⁵, R-Y Carlier⁶, P Laforêt⁷, G Nicolas³

Affiliations

¹ Department of Neurology, Raymond-Poincaré Hospital, AP-HP, 104, boulevard Raymond-Poincaré, 92380 Garches, France. Electronic address: marion.brisset@aphp.fr.
² Department of Physiology, Raymond-Poincaré Hospital, AP-HP, 104, boulevard Raymond-Poincaré, 92380 Garches, France.
³ Department of Neurology, Raymond-Poincaré Hospital, AP-HP, 104, boulevard Raymond-Poincaré, 92380 Garches, France.
⁴ Department of Clinical nutrition, Raymond-Poincaré Hospital, AP-HP, 104, boulevard Raymond-Poincaré, 92380 Garches, France.
⁵ Department of Rehabilitation, Cochin Hospital, AP-HP, 27, rue du Faubourg Saint-Jacques, 75014 Paris, France.
⁶ Department of Imagery, Raymond-Poincaré Hospital, AP-HP, 104, boulevard Raymond-Poincaré, 92380 Garches, France.
⁷ Paris-Est Neuromuscular Center, GH Pitié-Salpêtrière, AP-HP, 75013 Paris, France.

PMID: 33640114
DOI: 10.1016/j.neurol.2020.10.012

Abstract

Deficiency neuropathies and rhabdomyolysis have previously been reported after bariatric surgery (BS) but never myopathies. We report cases of five patients with morbid obesity who developed within 2 to 4 months of a BS, proximal myopathy following significant and rapid weight loss worsened by postoperative gastrointestinal complications. Muscle weakness concerned lower limbs in particular in quadriceps and less frequently in upper limbs and diaphragm, sometimes mimicked a Guillain-Barré syndrome. Muscle biopsy performed in 1 patient, revealed selective atrophy of type 2 fibers. Weakness slowly decreased with refeeding with vitamins supplementation. We enlarge here the clinical pattern of post-BS complications.

Keywords: Bariatric surgery; DEXA scanner; MRI; Metabolic dysfunction; Myopathy.

MeSH terms

Bariatric Surgery* / adverse effects
Female
Guillain-Barre Syndrome*
Humans
Muscle Weakness / etiology
Obesity, Morbid* / surgery
Postoperative Complications / diagnosis
Postoperative Complications / etiology