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World J Gastroenterol. Jul 21, 2014; 20(27): 8764-8782
Published online Jul 21, 2014. doi: 10.3748/wjg.v20.i27.8764
Neurological disorders and inflammatory bowel diseases
Giovanni Casella, Gian Eugenio Tontini, Gabrio Bassotti, Luca Pastorelli, Vincenzo Villanacci, Luisa Spina, Vittorio Baldini, Maurizio Vecchi
Giovanni Casella, Vittorio Baldini, Medical Department, Desio Hospital, 20033 Desio, Italy
Gian Eugenio Tontini, Luca Pastorelli, Luisa Spina, Maurizio Vecchi, Gastroenterology and Gastrointestinal Endoscopy Unit, IRCCS Policlinico San Donato, 20097 San Donato Milanese, Italy
Gabrio Bassotti, Gastroenterology Section, Department of Medicine, University of Perugia Medical School, 06123 Perugia, Italy
Luca Pastorelli, Maurizio Vecchi, Department of Biomedical Sciences for the Health, University of Milan, 20146 Milan, Italy
Vincenzo Villanacci, Institute of Pathology, Spedali Civili, 25123 Brescia, Italy
Author contributions: All authors designed and wrote the current review article.
Correspondence to: Maurizio Vecchi, MD, Gastroenterology and Gastrointestinal Endoscopy Unit, IRCCS Policlinico San Donato, via Morandi 30, 20097 San Donato Milanese, Italy. maurizio.vecchi@unimi.it
Telephone: +39-2-52774655 Fax: +39-2-52774655
Received: October 28, 2013
Revised: February 14, 2014
Accepted: April 15, 2014
Published online: July 21, 2014
Abstract

Extraintestinal manifestations occur in about one-third of patients living with inflammatory bowel disease (IBD) and may precede the onset of gastrointestinal symptoms by many years. Neurologic disorders associated with IBD are not frequent, being reported in 3% of patients, but they often represent an important cause of morbidity and a relevant diagnostic issue. In addition, the increasing use of immunosuppressant and biological therapies for IBD may also play a pivotal role in the development of neurological disorders of different type and pathogenesis. Hence, we provide a complete and profound review of the main features of neurological complications associated with IBD, with particular reference to those related to drugs and with a specific focus on their clinical presentation and possible pathophysiological mechanisms.

Keywords: Inflammatory bowel diseases, Crohn’s disease, Ulcerative colitis, Extraintestinal manifestations, Neurological disorders, Multiple sclerosis, Progressive multifocal encephalopathy, Demyelinating neuropathies, Cerebrovascular diseases, Side effects

Core tip: Extraintestinal manifestations occur in about one-third of patients with inflammatory bowel disease (IBD) and may precede the onset of gastrointestinal symptoms by many years. Neurological disorders are uncommon in IBD but they can represent an important cause of morbidity and relevant diagnostic issue. Furthermore, the use of immunosuppressant and biological therapies for IBD may also play a pivotal role in the development of neurological disorders. Hence, we review the main features of neurological complications associated with IBD, with particular reference to those related to drugs, thereby focusing on their clinical presentation and possible pathophysiological mechanisms.