Bariatric surgery raises likelihood of developing epilepsy: Study

CANADA: According to a retrospective Canadian study that was published in the Neurology journal, patients who have had bariatric surgery are more likely to develop epilepsy.

The weight loss procedure known as bariatric surgery, which includes changing the digestive tract, has grown in popularity. The study indicated that bariatric surgery recipients have a higher risk of epilepsy, despite the fact that it is an effective treatment for obesity and obesity-related chronic illnesses like high blood pressure and type 2 diabetes.

The results corroborated earlier studies in Sweden that had found increased risks of epilepsy and seizures following gastric bypass surgery. The Swedish study highlighted that although "this possible relationship has not been properly studied," bariatric surgery "may be an undiscovered epilepsy risk factor."

The researchers hypothesized that malabsorption might be a factor. They noted that there has been some research, however limited, into the role of vitamin deficiencies in epilepsy.

The goals of the study were to quantify the risk of epilepsy after bariatric surgery for weight loss in comparison to a non-surgical cohort of individuals with an obesity diagnosis and to pinpoint the risk variables for epilepsy among those who had undergone the procedure.

Researchers identified individuals who underwent bariatric surgery during a six-year period by looking through health information from Ontario, Canada. 16,958 patients who had undergone bariatric surgery were included in the study after those having a history of seizures, epilepsy, psychiatric illnesses, or drug or alcohol addiction were excluded. They were contrasted with 622,514 obese people who were not bariatric surgery patients. A minimum of three years of follow-up was provided for participants. The participants' average age was around 47, and almost two thirds of them were females. Patients were monitored during the research until December 2019. In the exposed cohort, the total and median follow-up amounted to 3,691,411 and 5.8 person-years, while in the unexposed cohort, it was 3,818,669 and 5.9 person-years.

Key results of the study:

• 73 persons, or 0.4% of those who underwent bariatric surgery, went on to acquire epilepsy, as opposed to 1,260 people, or 0.2% of those who did not.
• Investigators found that the estimated rates of epilepsy were 50 per 100,000 person-years among those who underwent bariatric surgery and 34 per 100,000 person-years among those who did not, after controlling for additional factors that may affect the risk of epilepsy, such as diabetes and high blood pressure.
• Compared to those who did not receive bariatric surgery, those who did had a 45% higher risk of having epilepsy.
• Following bariatric surgery, those who experienced a stroke were 14 times more likely to get epilepsy than those who did not have a stroke.

The researchers concluded that future studies "should aim to offer a more exact estimate of the influence of stroke developing after bariatric surgery on epilepsy risk."

People should discuss the advantages and disadvantages of bariatric surgery with their doctors before deciding to have it, according to Burneo. "Even though losing weight has numerous positive health effects, our research indicates that there is a long-term risk of epilepsy associated with bariatric surgery for weight loss. Future studies should examine the consequences of bariatric surgery and look at epilepsy as a potential long-term side effect "the authors claimed.

REFERENCE

Antaya TC, et al "Epilepsy risk following bariatric surgery for weight loss" Neurology 2022; DOI: 10.1212/WNL.0000000000201100.