Using the above approach to encephalopathy you can start to think about the possible causes of encephalopathy in the medical patient.
Specifically a sleeve gastrectomy coupled with post operative nausea and vomiting can cause thiamine deficiency and Wernicke's Encephalopathy. However the classic triad of encephalopathy, oculomotor dysfunction and gait ataxia are only seen in 16% of patients with Wernicke's Encephalopathy.
The two vitamin deficiencies that can cause altered mental status are Niacin deficiency (B3) and Thiamine deficiency (B1).
Interested in reading more? Here is a case report of Wernicke's Encephalopathy post sleeve gastrectomy as in our case.