To the Editor.
—We read with great interest the report by Paulson et al1 concerning the neurologic complications of gastric partitioning. In our earlier report,2 patient 2 was markedly psychotic. We did not emphasize this aspect because we had no information about her previous psychiatric status except that she was below average in intelligence. Now that additional examples of psychosis occurring together with sensory neuropathy have been described in patients who have undergone gastric partitioning, we agree that psychosis should be considered part of the overall syndrome. This neurologic syndrome may resemble porphyria, which will always need to be excluded in these patients because starvation is one of the potential precipitating factors in porphyria.Concerning the pathophysiology of this disorder, May3 has published a related case of a patient who was not obese and underwent gastric surgery that included a vagotomy, an antrectomy, and a Billroth II
Feit H, Glasberg MR. Neurologic Complications of Gastric Partitioning. Arch Neurol. 1986;43(7):642. doi:10.1001/archneur.1986.00520070004003