Department of Physiotherapy, University of West Attica, Egaleo, Greece
Department of Neurology, Hygeias Melathron, Athens, Greece.
BMJ Case Rep. 2023 May 18;16(5):e254456. doi: 10.1136/bcr-2022-254456.
Patients with inflammatory bowel disease (IBD) may present with extraintestinal manifestations. Neurological symptoms associated with IBD are infrequent. Thus, any unexplained neurological symptom that occurs in patients with IBD should raise the suspicion of a link between the two disorders. We report a case of a man in his 60s, who was diagnosed with Crohn's disease and developed ptosis and diplopia. Neurological examination revealed oculomotor nerve palsy, sparing the pupil. MRI and magnetic resonance angiography of the brain were insignificant and no other cause was determined. He was treated with oral corticosteroids and symptoms gradually subsided. Cranial nerve palsies associated with IBD have been rarely reported. They usually involve the optic and acoustic nerve and are attributed to a common dysimmune base. This is the first reported case of oculomotor nerve palsy (III cranial nerve) associated with IBD. Clinicians treating patients with IBD should be alert for unusual neurological complications and treat them appropriately.
炎症性肠病（IBD）患者可能会出现肠道外表现。与 IBD 相关的神经系统症状并不常见。因此，任何发生在 IBD 患者身上的不明原因的神经系统症状都应引起对这两种疾病之间关联的怀疑。我们报告了一例 60 多岁的男性，他被诊断患有克罗恩病，并出现上睑下垂和复视。神经系统检查显示动眼神经麻痹，瞳孔不受影响。脑部 MRI 和磁共振血管造影无明显异常，也未确定其他病因。他接受了口服皮质类固醇治疗，症状逐渐缓解。与 IBD 相关的颅神经麻痹很少见。它们通常涉及视神经和听神经，归因于共同的免疫失调基础。这是首例与 IBD 相关的动眼神经麻痹（III 对颅神经）的报告病例。治疗 IBD 患者的临床医生应警惕不常见的神经系统并发症并进行适当治疗。
