Keywords
Ischemic stroke
Peripheral neuropathies
Categories
How to Cite
Abstract
Introduction: The purpose of this retrospective study was to report neurological manifestations noted in patients who were monitored for inflammatory bowel disease, in order to document the pathophysiological, clinical, progressive, and therapeutic characteristics of this entity.
Material and methods: We conducted a retrospective study on patients monitored -in the gastroenterology service in Ibn Sina Hospital in Rabat, Morocco- for inflammatory bowel disease from 1992 till 2013 and who developed neurological manifestations during its course. Patients with iatrogenic complications were excluded, as well as patients with cerebrovascular risk factors.
Results: There were 6 patients, 4 of whom have developed peripheral manifestations. Electromyography enabled the diagnosis to be made and the outcome was favorable with the disappearance of clinical manifestations and normalization of the electromyography. The other 2 patients, monitored for Crohn’s disease, developed ischemic stroke. Cerebral computed tomography angiography provided a positive and topographic diagnosis. Two patients were admitted to specialized facilities.
Conclusion: Neurological manifestations in inflammatory bowel disease are rarely reported. Peripheral neuropathies and stroke remain the most common manifestations. The mechanisms of these manifestations are not clearly defined yet. Currently, we hypothesize the interaction of immune mediators.
References
Mendoza JL, Lana R, Taxonera C, Alba C, lzquierdo S, Díaz-Rubio M . Extraintestinal manifestations in inflammatory bowel disease: differences between Crohn’s disease and ulcerative colitis. Med Clin (Barc). 2005 Sep 10; 125(8): 297-300. https://doi.org/10.1157/13078423
Christos D, Konstantinos KH, Kosmido M, Tsianos EV. Neurologic manifestations in inflammatory bowel diseases: Current knowledge and novel insights. J Crohns Colitis. 2010 Jun; 4(2), 115–124. https://doi.org/10.1016/j.crohns.2009.10.005
Benavente L, Moris G. Neurologic disorders associated with inflammatory bowel disease. Eur J Neurol. 2011 Jan; 18(1): 138–143. https://doi.org/10.1111/j.1468-1331.2010.03095.x
Jaussaud R, Deville JF. Les manifestations neurologiques centrales de la maladie de Crohn. La Rev Med Interne. 1999 Jun; 20 (6) : 527-30. https://doi.org/10.1016/s0248-8663(99)80089-7
Lossos A, River Y, Eliakim A, Steiner I. Neurologic aspects of inflammatory bowel disease. Neurology. 1995 Mar; 45(3 Pt 1): 416–21. https://doi.org/10.1212/wnl.45.3.416
Elsehety A, Bertorini TE. Neurologic and neuropsychiatric complications of Crohn’s disease. South Med J.1997 Jun; 90(6): 606–10. https://doi.org/10.1097/00007611-199706000-00005
Gondim FA, Brannagan TH 3rd, Sander HW, Chin RL, Latov N. Peripheral neuropathy in patients with inflammatory bowel disease. Brain. 2005 Apr; 128(Pt 4): 867-79. https://doi.org/10.1093/brain/awh429
Masson C, Perrotte P, Edery J, Dehen H. Maladie de Crohn révélée par un infarctus cérébral, Rôle favorisant d'un déficit en protéine C. Presse Med. 1997 Oct 11; 26(30):1432-3.
Sibai M, El Moutawakil B, Chourkani N, Bourezgui M, Rafai A, Slassi I. [Neurological manifestations of chronic inflammatory bowel disease]. Rev Neurol (Paris). 2008 Oct; 164(10): 859–65. https://doi.org/10.1016/j.neurol.2008.03.001
Gendelman S, Present D, Janowitz HD. Neurological complications of inflammatory bowel disease (IBD). Gastroenterology. 1982 ; 82 (Suppl) : p1065.
De la Fuente-Fernandez R, Rubio-Nazabal E, de la Iglesia-Martinez F. Guillain-Barre syndrome as an extraintestinal manifestation of Crohn’s disease. Postgrad Med J.1995 Jul; 71(837): 437–8. https://doi.org/10.1136/pgmj.71.837.437
Okiyama R, Yamada M, Tamaki M, Orimo S, Arai M. Mononeuropathy multiplex with ulcerative colitis. Intern Med. 1993 Aug; 32(8): 651–4. https://doi.org/10.2169/internalmedicine.32.651
M. Diagana, M. Khalil, P.M. Preux, M. Dumas, M O Jauberteau. [Polyradiculonévrites et campylobacter jejuni : aspects cliniques et physiopathologiques]. Med Trop (Mars). 2003; 63(1): 68-74. [Accessed 28th May 2021]. Available from: https://www.jle.com/fr/MedSanteTrop/2003/63.1/068-074%20Polyradiculon%C3%A9vrites%20et%20campylobacter%20Jejuni%20(Diagana).pdf
Zhang L, Si Ming M, Day Andrew S, Leach T, Lamberg A, Dutt S. Detection and Isolation of Campylobacter Species Other than C. jejuni from Children with crohn’s disease. J Clin Microbiol. 2009 Feb; 47(2):453-5. https://doi.org/10.1128/jcm.01949-08
Maire F, Beaugerie L, Cohen M, A Deschamps, J Cosnes, J Capeau, et al. [Factors associated with hyperhomocysteinemia in Crohn's disease]. Gastroenterol Clin Biol. Aug-Sep 2001 ; 25 (8-9) 745-8.
Koutroubakis IE, Dilaveraki E, Vlachonikolis I G, Vardas E, Vrentzos G, Ganotakis E, et al. Hyperhomocysteinemia in Greek patients with inflammatory bowel disease. Dig Dis Sci. 2000 Dec; 45(12): 2347-51. https://doi.org/10.1023/a:1005583606647
Cosnes J, Beaugerie L, Carbonnel F, Gendre JP. Smoking cessation and the course of Crohn's disease:
An intervention study. Gastroenterology 2001 Apr; 120(5):1093-9. https://doi.org/10.1053/gast.2001.23231
Maamar M, Tazi-Mezalek Z, Harmouche H, Ammouri W, Zahlane M, Adnaoui M, et al. Les troubles neurologiques par carence en vitamine B12 : étude rétrospective de 26 cas. Rev Méd Interne. 2006 Jun; 27(6):442-7. https://doi.org/10.1016/j.revmed.2006.01.012
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2015 Youssef Hnach et al.
