Acute CNS white matter lesions in patients with inflammatory bowel disease

Lau, Lonneke M. L. de; Vries, Juna M. de; Woude, Christien J. van der; Kuipers, Ernst J.; Siepman, Dorine A M; Hintzen, Rogier Q.

doi:10.1002/ibd.20792

Cited by 26 publications

(22 citation statements)

References 17 publications

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“…Although Geissler et al reported a significant increase in FWML (21), a subsequent study by Hart et al did not confirm their findings (22). While there are case reports which relate acute FWML with IBD, there is currently no sufficient prospective evidence for a conclusion (23). The present study showed results similar to those of Hart et.…”

Section: Discussioncontrasting

confidence: 55%

“…and suggested a normal frequency of FWML in IBD. FWML may be due to atherosclerosis, thrombosis, vasculitis or demyelination (22,23,24,25); the exact pathogenesis and clinical significance still remain controversial. The use of novel neuroimaging techniques, such as diffusion tensor imaging, may provide more insight on the microstructure and anatomy of affected white matter (26,27).…”

Section: Discussionmentioning

confidence: 99%

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İnflamatuvar Barsak Hastalığında Santral ve Periferik Nörolojik Belirtiler

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2012

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Ad dress for Cor res pon den ce/Ya z›fl ma Ad re si: Münevver Gökyiğit MD, Objective: The aim of this study is to evaluate the spectrum, frequency and coincidence of central and peripheral neurological involvement in a cohort of patients with inflammatory bowel disease (IBD). Ma te ri al and Met hod: Thirty consecutive patients, with a biopsy proven diagnosis of IBD (15 Crohn's disease, 15 ulcerative colitis) were enrolled and followed for a period of one year. Clinical neurological evaluations, electrodiagnostic examination and neuroimaging were performed in all patients. Neuroimaging findings were compared with an age-and sex-matched healthy control group. Re sults: Among the 25 patients who completed the study, mild peripheral neuropathy was the most commonly encountered neurologic pathology. Twelve percent had distal symmetrical sensory and sensorimotor polyneuropathy, and 16% had mononeuropathy. Peripheral neuropathy predominantly affected females (p<0.05). Focal white matter lesions were demonstrated in 20.8% of the patients, which was not significantly different from the control group (p>0.05). Seizure disorder and steroid myopathy occurred once each during the study period. Concurrent central and peripheral nervous system pathologies were detected in three cases with longer disease duration. Two new neurological incidents were observed during the one year follow-up period and included cranial mononeuropathy and cerebral venous thrombosis in two patients. Dis cus si on: Our findings suggest higher vulnerability of the peripheral nerves among women throughout the course of inflammatory bowel disease. Focal white matter lesions appear unlikely to represent another neurological manifestation of IBD. Larger controlled prospective studies should be conducted in order to observe common etiological pathways and identify the nature of neurological involvement in IBD.

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Section: Discussioncontrasting

confidence: 55%

Section: Discussionmentioning

confidence: 99%

İnflamatuvar Barsak Hastalığında Santral ve Periferik Nörolojik Belirtiler

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2012

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“…The lesions are nonspecific and may be seen with accelerated small‐vessel ischemic disease, vasculopathies, migraine, Lyme disease, and as a residual from inflammatory or traumatic brain damage (de Lau et al. 2009; Akashbi et al. 2012; Bashir et al.…”

Section: Discussionmentioning

confidence: 99%

Magnetic resonance brain imaging in patients with visual vertigo

et al. 2015

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IntroductionPatients with visual vertigo (VV) report dizziness provoked by moving visual surroundings. It has been suggested that these subjects develop a compensation strategy for a vestibulo‐proprioceptive deficit and rely excessively on visual input. We have postulated that patients with VV might have brain abnormalities that interfere with appropriate processing of visual stimulation and performed a brain MRI study to verify this hypothesis.Materials and MethodsPatients with VV of more than 3 months duration were included. They were asked to complete the Situational Characteristic Questionnaire (SCQ) that scores for the symptoms of VV. Dizzy patients without VV served as controls. A brain MRI was performed with a Siemens 1.5 Tesla scanner in patients and controls.ResultsTwenty‐four patients with VV were included. Their mean SCQ score was 1.45 ± 0.9 (normal 0.16 ± 0.28). In 50% of patients, abnormalities in MRI imaging were found. Thirty‐three percent of 27 controls demonstrated an abnormal brain MRI. The two groups were similar in respect to the prevalence of a localized hemispheric or posterior fossa lesion (P = 0.13), but VV patients had more unspecific white matter brain changes than controls (P = 0.009). Patients and controls did not differ in age and gender distribution (P = 0.9) or the history of a neurotological event preceding their symptoms (P = 0.3).ConclusionsOur study suggests that multiple white matter lesions might contribute to occurrence of the phenomenon of VV. Future prospective large‐scale studies by specific MR techniques are indicated to validate our preliminary findings and elucidate the pathological mechanism of VV.

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“…For example, in five IBD patients with acute neurological deficits, white matter lesions of the CNS have been found with MRI,17 and Nemoto et al18 have reported a patient with UC who had sensorineural deafness, brainstem encephalopathy, and white matter lesions. However, studies with asymptomatic patients are relatively scarce.…”

Section: Discussionmentioning

confidence: 99%

Asymptomatic Brain Lesions on Cranial Magnetic Resonance Imaging in Inflammatory Bowel Disease

Dolapcioglu¹,

Guleryuzlu²,

Uygur-Bayramiçli³

et al. 2013

Gut Liver

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Background/AimsThis study aimed to examine the frequency and type of asymptomatic neurological involvement in inflammatory bowel disease (IBD) using cranial magnetic resonance imaging (MRI).MethodsFifty-one IBD patients with no known neurological diseases or symptoms and 30 controls with unspecified headaches without neurological origins were included. Patients and controls underwent cranial MRI assessments for white matter lesions, sinusitis, otitis-mastoiditis, and other brain parenchymal findings.ResultsThe frequencies of white matter lesions, other brainstem parenchymal lesions, and otitis-mastoiditis were similar in IBD patients and controls (p>0.05), whereas sinusitis was significantly more frequent in IBD patients (56.9% vs 33.3%, p=0.041). However, among those subjects with white matter lesions, the number of such lesions was significantly higher in IBD patients compared to controls (12.75±9.78 vs 3.20±2.90, p<0.05). The incidence of examined pathologies did not differ significantly with disease activity (p>0.05 for all).ConclusionsThe incidence of white matter lesions seemed to be similar in IBD patients and normal healthy individuals, and the lesions detected did not pose any clinical significance. However, long-term clinical follow-up of the lesions is warranted.

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Acute CNS white matter lesions in patients with inflammatory bowel disease

Abstract: These cases, together with previous reports, suggest that white matter lesions may be another extraintestinal manifestation of inflammatory bowel disease.

Cited by 26 publications

References 17 publications

İnflamatuvar Barsak Hastalığında Santral ve Periferik Nörolojik Belirtiler

İnflamatuvar Barsak Hastalığında Santral ve Periferik Nörolojik Belirtiler

Magnetic resonance brain imaging in patients with visual vertigo

Asymptomatic Brain Lesions on Cranial Magnetic Resonance Imaging in Inflammatory Bowel Disease

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