Gastroparesis secondary to a demyelinating disease: a case series

Abstract

Background: Gastroparesis has a number of etiologies. The main ones are secondary to a complication from diabetes mellitus, related to post vagotomy or post gastric surgical resections, or idiopathic when the etiology is unclear. Gastroparesis secondary to a demyelinating disease of the brain is unusual.

What the Gut Can Teach Us About Migraine

“…Animal studies demonstrate pyloric relaxation induced by gastric distension is significantly reduced by subdiaphragmatic vagotomy, thereby prohibiting food passage [24]. Furthermore, demyelinating disease in the medullary region of the brainstem, presumably the vagal nerve nuclei, secondary to multiple sclerosis, has been correlated with gastroparesis and abnormal gastric emptying studies [25].…”

Other Forms of Gastroparesis

“…Delayed gastric emptying, 75 isolated cases of gastroparesis, [76][77][78][79] and even an instance of gastric perforation 80 have been reported in multiple sclerosis, with their cause attributed to autonomic dysfunction of central origin. 81 In one small series, parallel improvements in neurologic and gastric emptying function were documented in response to corticosteroid therapy.…”

“…81 In one small series, parallel improvements in neurologic and gastric emptying function were documented in response to corticosteroid therapy. 79 …”

Gastric stasis in migraineurs: Etiology, characteristics, and clinical and therapeutic implications

“…Demyelinating lesions in the brain stem, presumably affecting the vagal nerve nuclei, may give rise to GS (13). In a case series, two female patients presented with intractable nausea, vomiting, cerebellar deficits, dysphagia, and paresthesias.…”

“…Both of these patients had an abnormal gastric emptying test. Treatment of the brain lesions with corticosteroids led to simultaneous improvement in gastric emptying and reduction in size of the brain lesions, suggesting a common etiology (13). …”