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[炎症性肠病中的神经系统并发症]

[Neurologic complications in inflammatory bowel diseases].

作者信息

Töpper R, Gartung C, Block F

机构信息

Neurologische Klinik, Universitätsklinikum Aachen, Pauwelsstrasse 30, 52057 Aachen.

出版信息

Nervenarzt. 2002 Jun;73(6):489-99; quiz 500-1. doi: 10.1007/s00115-002-1335-y.

Abstract

Some inflammatory diseases of the gastrointestinal system are associated with neurological symptoms which, in rare cases, may precede the onset of the gastrointestinal manifestation of the disease. Celiac sprue is characterized by an intolerance to the wheat protein gluten. The typical neurological manifestation of celiac sprue is cerebellar ataxia. The ataxia as well as the gastrointestinal symptoms can be treated with a strictly gluten-free diet. The neurological symptoms of Whipple's disease, a disorder caused by gram-positive bacilli, are variable. Typical symptoms of cerebral Whipple's disease include dementia, ophthalmoplegia, movement disorders, and signs of hypothalamic dysfunction. Nowadays, the diagnosis of cerebral Whipple's disease is made by PCR detection of the bacilli in the CSF. Crohn's disease and ulcerative colitis are associated with neurological symptoms to a similar proportion. Various forms of polyneuropathies have been observed. The CNS manifestations of inflammatory bowel diseases include thromboembolic stroke, cerebral venous thrombosis, and cerebral vasculitis.

摘要

一些胃肠道系统的炎症性疾病与神经症状相关,在罕见情况下,这些神经症状可能先于疾病的胃肠道表现出现。乳糜泻的特征是对小麦蛋白麸质不耐受。乳糜泻的典型神经表现是小脑共济失调。共济失调以及胃肠道症状可以通过严格的无麸质饮食来治疗。惠普尔病是一种由革兰氏阳性杆菌引起的疾病,其神经症状多变。脑型惠普尔病的典型症状包括痴呆、眼肌麻痹、运动障碍和下丘脑功能障碍的体征。如今,脑型惠普尔病的诊断是通过脑脊液中杆菌的PCR检测来进行的。克罗恩病和溃疡性结肠炎与神经症状的关联比例相似。已经观察到各种形式的多发性神经病。炎症性肠病的中枢神经系统表现包括血栓栓塞性中风、脑静脉血栓形成和脑血管炎。

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