GASTRIC BYPASS

 

Study - Seizure Increase Not Seen Following Gastric Bypass

I am sharing this particular study because I am a seizure patient following gastric bypass who has a list of about 160 people with a similar issue.  

This makes me happy, relieved even...and a little sad at the same time.  Why?  Because it would be REALLY REALLY GREAT if someone found a definitive trigger for us who have conditions like this.

Seizure Increase Not Seen Following Gastric Bypass

By: MIRIAM E. TUCKER, Clinical Psychiatry News Digital Network

BALTIMORE – No notable increases in new-onset seizure disorder or exacerbations of a pre-existing seizure disorder were seen following gastric bypass surgery in a retrospective case series of more than 1,500 patients from the Mayo Clinic.

Reports of new-onset or exacerbated seizure disorders following Roux-en-Y surgery are often posted on epilepsy patient-oriented Web sites such as epilepsy.com, along with reports of other neurologic complications such as Wernicke-Korsakoff syndrome, polyradiculoneuropathy, myelopathy, and optic neuropathy. However, few previous studies have examined a potential connection between gastric bypass and epilepsy, Dr. Richard S. Clemmons and Gregory D. Cascino said in a poster at the annual meeting of the American Epilepsy Society.

A diagnosis of epilepsy pre-existed prior to Roux-en-Y surgery in 12 of 1,542 patients who were operated on at the Mayo Clinic between September 1997 and September 2007. Those patients were selected from a larger group of 1,776 patients because they had more than 1 year of follow-up, had undergone surgery for morbid obesity, and were aged 18 years or older. Despite evidence that gastric bypass surgery might result in decreased absorption of drugs with high proximal absorption or low pH (Am. J. Health Syst. Pharm. 2006;63:1852-7), 8 of these 12 patients had no decrease in drug levels, based on patient report or on serum testing before and after surgery. One patient who did have a low drug level was suspected of poor compliance. None of the 12 had exacerbations of their seizures.

"Based on the limited data here, there was not a decrease in serum drug levels for valproic acid, carbamazepine, or levetiracetam. ... Even patients with significant seizure risk factors did not manifest an exacerbation of seizures," noted Dr. Clemmons and Dr. Cascino, both of whom were affiliated with the division of epilepsy in the department of neurology at the Mayo Clinic, Rochester, Minn., at the time of the study. Dr. Clemmons is currently in private practice in Denver.

Only 5 of the 1,542 patients developed new-onset epilepsy following surgery. Of those, only 3 (1.9% of the total cohort) could be considered to have unprovoked epilepsy. One of the other two patients had a history of meningoencephalitis and had just a single seizure 2 years after surgery that was possibly associated with hypoglycemia. The other one had a seizure in the setting of a stroke 3 months after surgery. None of the five developed intractable epilepsy.

About three-fourths of the patients in the study were female. Their charts were examined for evidence of seizure exacerbation post surgery, defined as an increase in seizure frequency above preoperative baseline where another cause was not identified. Patient questionnaires were used to supplement where data were lacking.

"Based on the reviewed data, there is no clear exacerbation of preexisting seizure disorder following gastric bypass ... Most patients with seizure disorder do well following Roux-en-Y," they concluded.

 

 Thanks for answering my question Beth .   

Now  I have an interesting theory to offer in return (  lets hope it doesn't  get censored for " going off on a tangent "  

WHAT IF  -  because our bodies KNOW on some level that we  may be more vulnerable than most  people ... to electrical brainstorms  and even possibly seizures from just dieting ( self created  hypoglycemic state in other words ) .. maybe THATS why some of us  couldn't  diet very successfully pre op .

I know I NEVER have been able to .  I can MOVE more  but I can't eat less ... because  I get VERY VERY lightheaded and feel really BAD .  

Maybe I should stop beating myself up for snacking  and   recognize that my body is just trying to keep itself healthy .. and that hypoglycemic  , starvation states are just NOT an option for me .

Sounds to me like you , Beth  have already come to this conclusion.  

 I have a brain malformation.

I go for 7-10 days of video EEG in a few weeks to try (once again) to highlight the part of my brain that is causing my seizures.

The biggest question remains -- why did it not start UNTIL I lost 170 pounds.... if it is indeed a genetic problem?  

I do not blame the RNY.

Polymicrogyria is a condition characterized by abnormal development of the brain before birth. The surface of the brain normally has many ridges or folds, called gyri. In people with polymicrogyria, the brain develops too many folds, and the folds are unusually small. The name of this condition literally means too many (poly-) small (micro-) folds (-gyria) in the surface of the brain.

Polymicrogyria can affect part of the brain or the whole brain. When the condition affects one side of the brain, researchers describe it as unilateral. When it affects both sides of the brain, it is described as bilateral. The signs and symptoms associated with polymicrogyria depend on how much of the brain, and which particular brain regions, are affected.

Researchers have identified multiple forms of polymicrogyria. The mildest form is known as unilateral focal polymicrogyria. This form of the condition affects a relatively small area on one side of the brain. It may cause minor neurological problems, such as mild seizures that can be easily controlled with medication. Some people with unilateral focal polymicrogyria do not have any problems associated with the condition.

Bilateral forms of polymicrogyria tend to cause more severe neurological problems. Signs and symptoms of these conditions can include recurrent seizures (epilepsy), delayed development, crossed eyes, problems with speech and swallowing, and muscle weakness or paralysis. The most severe form of the disorder, bilateral generalized polymicrogyria, affects the entire brain. This condition causes severe intellectual disability, problems with movement, and seizures that are difficult or impossible to control with medication.

There are definitely some bad possible side effects of WLS, but this one is so very rare that I don't htink you should worry about it.

Haev you visited the Revision board here? How about the Failed WLS and the Regrets boards?

I am 7 months post-op 2 months ago I woke up in the back of an ambluance from a grand mal seziure.  of course the surgeon says its 'not related.'  I also know 3 other people that have had RNY and the same thing has happened to them.  My brother is 2 year post-op, also have seziures, a brain tumor, and cluster heads now.  He is moving to FL now because his doctors are transfering him to the Mayo clinic for treatments because they cant figure out what else to do. And also 'unrelated' to his RNY.

this sounds like fear mongering to me. I can't see why there would be a link.

its weird ur asking like it is the rule that most post-ops DO have seizures.

ive NEVER known ANY of the post-ops I know in real life to have seizures. ive also never heard of any of the post-ops on HERE to have seizures except Beth (Melting Mama on here).

then again, i dont post that often on here anymore, so maybe there's been some sort of weird siezure outbreak i've missed?