http://link.springer.de/link/service/journals/10072/bibs/1022008/1022s117.htm
Online publication: December 5, 2001
Neurological Sciences
Abstract Volume 22 Issue 8 (2001)
pp S117-S122
A. Ghezzi, M. Zaffaroni
Centro Studi Sclerosi Multipla,
Ospedale di Gallarate, Università di Milano, Via Pastori 4, I-21013
Gallarate, Varese, Italy
Abstract.
Neurological manifestations of gastrointestinal
disorders are described, with particular reference to those resembling
multiple sclerosis (MS) on clinical or MRI grounds.
Patients with celiac disease can
present cerebellar ataxia, progressive myoclonic ataxia, myelopathy, or
cerebral, brainstem and peripheral nerve involvement.
Antigliadin antibodies can be found
in subjects with neurological dysfunction of unknown cause, particularly
in sporadic cerebellar ataxia ("gluten ataxia").
Patients with Whipple's disease can
develop mental and psychiatric changes, suprancuclear gaze palsy, upper
motoneuron signs, hypothalamic dysfunction, cranial nerve abnormalities,
seizures, ataxia, myorhythmia and sensory deficits.
Neurological manifestations can complicate
inflammatory bowel disease (e.g. ulcerative colitis and Crohn's disease)
due to vascular or vasculitic machanisms.
Cases with both Crohn's disease and
MS or cerebral vasculitis are described.
Epilepsy, chronic inflammatory polyneuropathy,
muscle involvement and myasthenia gravis are also reported.
The central nervous system can be
affected in patients with hepatitis C virus (HCV) infection because of
vasculitis associated with HCV-related cryoglobulinemia.
Mitochondrial neurogastrointestinal
encephalopathy (MNGIE) is a disease caused by multiple deletions of mitochondrial
DNA.
It is characterized by peripheral
neuropathy, ophthalmoplegia, deafness, leukoencephalopathy, and gastrointestinal
symptoms due to visceral neuropathy.
Neurological manifestations can be
the consequence of vitamin B1, nicotinamide, vitamin B12, vitamin D, or
vitamin E deficiency and from nutritional deficiency states following gastric
surgery.
© Springer-Verlag Italia 2001