Neurologic Aspects of Inflammatory Bowel Disease

• Published in: Neurology Vol. 45; no. 3; pp. 416 - 421
• Main Authors: Lossos, A, River, Y, Eliakim, A, Steiner, I
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD American Academy of Neurology 01-03-1995; Lippincott Williams & Wilkins
• Subjects: Adult; Aged; Biological and medical sciences; Child; Female; Gastroenterology. Liver. Pancreas. Abdomen; Humans; Inflammatory Bowel Diseases - complications; Inflammatory Bowel Diseases - physiopathology; Male; Medical sciences; Middle Aged; Nervous System Diseases - complications; Nervous System Diseases - physiopathology; Other diseases. Semiology; Retrospective Studies; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Human; Crohn disease; Symptomatology; Nervous system diseases; Digestive diseases; Intestinal disease; Complication; Neurological disorder; Inflammatory disease; Ulcerative colitis
• ISSN: 0028-3878; 1526-632X
• DOI: 10.1212/WNL.45.3.416

Article abstract-To determine the frequency, spectrum, and clinical features of neurologic disorders associated with ulcerative colitis (UC) and Crohn's disease (CD). BackgroundExtraintestinal manifestations of inflammatory bowel disease (IBD) are well documented, but the association of IBD with neurologic involvement is rare and often controversial. MethodsTertiary care center ambulatory and hospital services data bank retrospective computerized search with subsequent file review. PatientsFrom among 638 IBD patients diagnosed from 1981 to 1991, we identified 10 CD patients and nine UC patients with neurologic involvement unrelated to a defined systemic or iatrogenic cause. Neurologic disorders diagnosed 15 or more years before the intestinal symptomatology were excluded. ResultsThree percent of IBD patients had neurologic involvement. In 14 of 19 (74%), it started within a mean of 5.7 years (range, 0.7 to 12 years) after the diagnosis of bowel disease, and in two of 19 (10%) it occurred at the time of IBD exacerbation. During the course of IBD, 10 of 19 patients (53%) exhibited other extraintestinal manifestations. Peripheral nerve disorders were observed in six UC patients. Myelopathy (5 patients), myopathy (3), and myasthenia gravis (1) were diagnosed in eight CD patients and one UC patient. Cerebrovascular disorders occurred in two UC and two CD patients. ConclusionsNeurologic disorders associated with IBD are more common than appreciated and follow a different pattern of involvement in UC and CD. A prospective study is required to define the nature of this association.
NEUROLOGY 1995;45416-421