Inflammatory bowel disease: An increased risk factor for neurologic complications

Table 1 Clinical studies of neurologic disorders in inflammatory bowel disease

Author	Year	Country	Study design	Total patients	Type of IBD	Patients with NC	Age (range, yr)	Sex	Other EIM	Associated with IBD exacerbation	Incidence of NC
Lossos et al[21]	1995	Israel	Retrospective, computerized search	638	377 CD261 UC	10 CD patients9 UC patients	11-71	11 M8 F	50%	2 patients (10%)	19 patients (3%)
Elsehety et al[15]	1997	United States	Retrospective	253	CD	Probable: 49 patients Possible: 35 patients Total: 84 patients	NR	NR	NR	5 patients (6%)	Probable: 19.3% Possible: 13.9%Total: 33.2%
Oliveira et al[14]	2008	Brazil	Prospectively, clinic-based, PN especially studied	82	31 CD51 UC	16 CD patients23 UC patients	43 CD151 UC	15 M24 F	NR	NR	PN:51.6% CD45.1% UC Headache:54.8% CD57% UC
Sassi et al[23]	2009	Tunis	Prospective, prevalence study PN	102	88 CD14 UC	6 UC patients23 CD patients	22-64	7 F2 M	33%	29%	8.80%
Benavente et al[12]	2011	Spain	Retrospective, hospitalized patients	84	NR	13 UC patients12 CD patients	17-74	12 M13 F	4%	10 patients (40%)	30%
Shen et al[20]	2012	United States	Questionnaire-based, study of PN symptoms only	173	102 CD71 UC	67 patients	NR	NR	NR	NR	38.70%
Figueroa et al[18]	2013	United States	Retrospective, observational population based-cohort	772	342 CD430 UC	9 patients/12 events6 UC patients3 CD patients	21-83	5 F4 M	NR	8 patients	72 patients/100000 person-years
Babali et al[17]	2013	Greece	Prospective study of subclinical PN in asymptomatic patients	453	30 CD15 UC	0 patients	NR	NR	NR	NR	No patients had subclinical neuropathy

¹Mean age;

²Three patients had mononeuropathies due to rapid weight loss. Three patients had sensory large-fiber polyneuropathy and two had small-fiber polyneuropathy. One patient had a sensorimotor axonal PN. An etiological factor was identified in four cases (diabetes mellitus and long-term metronidazole treatment);

³Two patients were excluded: one had history of acute motor sensory polyneuropathy complicating UC and other patient had incidental carpal tunnel syndrome. IBD: Inflammatory bowel disease; NC: Neurologic complications; EIM: Extraintestinal complications; CD: Crohn’s disease; UC: Ulcerative colitis; F: Female; M: Male; NR: Not reported; PN: Peripheral neuropathy.

Table 2 Neurologic disorders associated with inflammatory bowel disease reported in the literature

Cerebrovascular disease

Cerebral infarction

Transient brain ischemia

Cerebral venous thrombosis

Demyelinating disease

Multiple sclerosis

Asymptomatic focal white-matter lesions

Myelopathy

Optic neuritis

Inflammatory pseudotumor

Epilepsy

Seizures

Psychosis

Chorea

Major depression

Autonomic nervous system dysfunction

Vasculitis of the central nervous system

Restless legs syndrome

Sleep disruption

Headache

Cranial neuropathies

Melkersson-Rosenthal syndrome

Sensorineural hearing loss

Ischemic optic neuropathy

Bell’s palsy

Neuromuscular diseases

Myasthenia gravis

Myopathy

Dermatomyositis

Polymyositis

Vacuolar myopathy

Peripheral neuropathy

Sensory large-fiber polyneuropathy

Small-fiber polyneuropathy

Acute and chronic immune-mediated neuropathies

Monophasic immune radiculoplexus neuropathy

Chronic distal sensorimotor polyneuropathy

Mononeuritis multiplex