A 22-year-old man presented to a hospital with – Nausea Vomiting Constipation associated with poor oral intake Progressive bilateral lower limb weakness Blurred vision Gait disturbance Insidious bilateral lower numbness Confabulation of memory and current events History The patient suffered from morbid obesity. As a treatment for obesity, he had undergone laparoscopic sleeve gastrectomy (LSG) two months before the current presentation. He had lost 20 kgs in two months. Investigations A physical examination revealed – Disorientation concerning time and place.
Insufficient response and diplopia. Weakness in the bilateral lower limbs [muscle power: 3/5 in bilateral lower limbs, 5/5 in upper limbs on medical research council scale] Decreased deep tendon reflex in the lower limbs. Upper gastrointestinal endoscopy revealed Grade A gastroesophageal reflux disease without obstruction.…
