Neurological manifestations of chronic inflammatory bowel disease

Introduction. - Several extra-intestinal manifestations of inflammatory bowel disease have been reported, although reports of neurologic disorders are rare. Case reports. - We report two cases of peripheral and central neurological manifestations of inflammatory bowel disease. The first case is a 33-year-old woman who developed acute inflammatory demyelinating motor polyneuropathy in association with Crohn's disease. Her symptoms improved with immunomodulatory therapies. Our second case is a 46-year-old woman, previously diagnosed with ulcerative colitis that subsequently developed ischemic stroke concomitantly to severe exacerbation of digestive symptoms. Her radial and humeral pulses were unequal bilaterally. Associated Takayashu's arteritis was suspected. The cardiovascular and immunological assessments were negative. Complementary investigations were foreseen but the patient died early of acute abundant rectal bleeding. Conclusion. - This paper focuses essentially on the probable manifestations of inflammatory bowel disease in the nervous system, particularly peripheral neuropathies and stroke. We discuss different pathophysiologic mechanisms incriminated, notably thromboembolism and immunological abnormalities. (C) 2008 Elsevier Masson SAS. Tous droits reserves.