Neurological Manifestations of Inflammatory Bowel Disease

Plata‐Bello, Julio; Acosta-López, Silvia

doi:10.5772/intechopen.73017

New Concepts in Inflammatory Bowel Disease 2018

DOI: 10.5772/intechopen.73017

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Neurological Manifestations of Inflammatory Bowel Disease

Julio Plata‐Bello¹,

Silvia Acosta-López²

Abstract: The inlammatory bowel disease (IBD) is associated with diferent neurological and psychiatric disorders, which are integrated among the extra-intestinal manifestation of this disease. The physiopathology of neurological manifestations of IBD varies among the diferent kind of complications. The origin and the signiicance of these manifestations must be understood by clinicians who manage IBD patients. Some of them are related to therapeutic agents. The present chapter consists of a review of the most prevalent n… Show more

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Еxtraintestinal manifestations of inflammatory bowel disease

Uvarova¹

2020

Actual Problems of Modern Medicine

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Inflammatory bowel diseases, that include Crohn's disease and ulcerative colitis, are considered systemic processes since their symptoms and manifestations are not limited to the gastrointestinal tract. Extraintestinal manifestations are characteristic of inflammatory bowel disease and can be observed in almost every system of the patient’s body. Extraintestinal symptoms are present in approximately 42 % of patients with inflammatory bowel disease during the manifestation of the pathological process. They can also precede the onset of gastrointestinal symptoms. Nowadays, the pathogenesis of extraintestinal manifestations of inflammatory bowel disease is not completely obvious. It is currently believed that the mucous membrane of the patient's gastrointestinal tract can provoke an immune response in the extraintestinal areas due to the presence of common epitopes in individuals with a genetic predisposition. Extraintestinal symptoms are most often observed in the joints (peripheral and axial arthropathy), skin (nodular erythema, gangrenous pyoderma, aphthous stomatitis), visual organ (episcleritis, uveitis) and hepatobiliary system (primary sclerosing cholangitis). Other organs and systems of the body, such as the lungs, kidneys, pancreas and venous system, are also affected; however, their damages are much less common. Some extraintestinal manifestations, for instance arthritis of several joints, erythema nodosum, episcleritis, and aphthous ulcers of the oral cavity, are associated with inflammatory activity in the intestine. Other extraintestinal symptoms, such as uveitis and ankylosing spondylitis, are not associated with inflammatory bowel disease activity. Manifestations like primary sclerosing cholangitis and gangrenous pyoderma may or may not be associated with inflammatory bowel activity. Extraintestinal manifestations of inflammatory bowel disease exacerbate the negative impact of the pathological process on the patient's quality of life, and some of them, such as venous thromboembolism, can be life-threatening.

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Еxtraintestinal manifestations of inflammatory bowel disease

Uvarova¹

2020

Actual Problems of Modern Medicine

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Neurological presentations of inflammatory bowel diseases

Shulpekova¹,

Ablaev

Damulin

2021

Medicinskij alfavit

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The aim. To characterize the main types of neurological manifestations in inflammatory bowel diseases – Crohn’s disease and ulcerative colitis.Main concepts. Neurological disorders represent an important aspect of extraintestinal inflammatory bowel diseases (IBD) manifestations. According to publications, the incidence of psycho-neurological syndromes varies from 0.25% to 47.50% that apparently depends on the patient’s selection in studies. Neurological signs are not always associated with IBD activity and may precede the manifestation of intestinal inflammation. The most typical include cerebral thromboembolism, peripheral and cranial neuropathies, demyelinating disorders, and cerebral vasculitis. The incidence of ischemic stroke in IBD can reach 6.4%, with approx. 20% of affected persons under 17 y.o. Hemiparesis is the predominant consequence. The risk of intracranial venous thrombosis is increased depending on the activity of intestinal inflammation; this complication can precede manifestation of IBD. Fifty per cent increased risk of multiple sclerosis in IBD patients was shown. The types of peripheral nerves involvement include mononeuropathy, plexopathy, multiple mononeuropathy, compression neuropathy, polyneuropathy and cranial neuropathy. Peripheral neuropathy may be found in 32–37% of IBD patients with a special examination. Demyelinating type, sensory axonal polyneuropathy with thin and thick fibers damage, and motor axonal polyneuropathy with thick fibers damage are observed approximately in equal proportions. It is important to differentiate ‘primary’ neuropathy with vitamin B12 and folic acid deficient, alcoholic, diabetic and drug-induced neuropathy. Clinical improvement is usually seen in the course of immunosuppressive therapy. Cranial neuropathy (mostly of II, VI, VII, VIII of cranial nerves) is described in IBD. Neurological disorders associated with administration of metronidazole, sulfasalazine, cyclosporin A, antibodies to TNF-α and integrins α4 and α4ß7 continue to be highly actual.Conclusion. There is a variety of neurologic syndromes in IBD which represents an important part of extraintestinal manifestations. Mild psychoneurological disorders may be not recognized in time. The majority of symptoms and signs may regress in the course of treatment of IBD and nutrients deficiency correction. The special attention should be paid to neurological status control while the biologic and immunosuppressor agents and metronidazole are administered.

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Neurological Manifestations of Inflammatory Bowel Disease

Cited by 2 publications

References 57 publications

Еxtraintestinal manifestations of inflammatory bowel disease

Еxtraintestinal manifestations of inflammatory bowel disease

Neurological presentations of inflammatory bowel diseases

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