Brain white-matter lesions in inflammatory bowel disease

Abstract

Geissler et al 1 Geissler A Andus T Roth M et al. Focal white-matter lesions in brain of patients with inflammatory bowel disease. Lancet. 1995; 345: 897-898 Crossref PubMed Scopus (110) Google Scholar reported that 42% of patients with Crohn's disease (CD) and 46% with ulcerative colitis (UC) have small white-matter lesions (WML) on magnetic resonance imaging (MRI) brain scans. These changes were found in only 16% of healthy controls. The authors suggested that these abnormalities might be of ischaemic origin, secondary to atherosclerosis or vasculitis. The possibility of demyelination has also been raised. 2 Agranoff D Schon F Are focal white matter lesions in patients with inflammatory bowel disease linked to multiple sclerosis?. Lancet. 1995; 346: 190 Abstract PubMed Google Scholar Their study was a neuroradiological one without any evaluation of whether the patients with WML had any neurological symptoms or signs. Neurological complications of inflammatory bowel disease are rare. The largest study of 638 patients reported an incidence of 3% of which 47% involved the central nervous system. 3 Lossos A River Y Eliamkim A Steiner I Neurologic aspects of inflammatory bowel disease. Neurology. 1995; 45: 416 Crossref PubMed Scopus (200) Google Scholar Evidence also exists for an association between inflammatory bowel disease (IBD) and multiple sclerosis. 4 Sadovnick AD Paty DW Yannakoulias G Concurrence of multiple sclerosis and inflammatory bowel disease. N Engl J Med. 1989; 321: 762-763 PubMed Google Scholar We set out to repeat the study and, in particular to assess the patients' neurological status.