2. Although malabsorption is generally considered to be
a gastrointestinal problem, the effects
of malabsorption extend far beyond the gastrointestinal tract
and can include neurologic dysfunction.
Pathophysiology :
• Disease processes that damage the enteric mucosa and
produce malabsorption can trigger neurologic dysfunction
both by immune-related processes, as in celiac disease,
and by impairing absorption of essential vitamins and
other nutrients
• vitamins deficiencies occur post-gastrectomy
3. minor neurological signs (restless legs syndrome, vibration
sense impairment and tactile hypoesthesia in both legs with
diminished ankle jerks and a prolonged or asymmetrical
Achilles-reflex time)
major neurological signs (subacute combined degeneration
with or without neuropathies, migraine , carpal tunnel
syndrome , vestibular dysfunction , seizures , and myelitis .
psychiatric disease including depression, personality
changes, or even psychosis .
4. Neurological complications of IBD
either related to drug therapy or spontaneously associated with
the disease
relatively frequent and may contribute to a high degree of
morbidity and permanent damage
or side effects to medication (CNS vasculitis: The most
common autoimmune manifestation associated with anti-TNF
therapy is the development of anti-nuclear antibodies and anti
ds-DNA autoantibodies without an associated clinical
syndrome)
5. Demyelinating peripheral neuropathies reported
during treatment with TNF-α antagonists. GBS is a
post-infectious, immune-mediated disease,
generally presenting as an acute inflammatory
demyelinating polyneuropathycharacterized by
ascending paralysis with rapid, progressive,
symmetric limb weakness and areflexia.
6. the neurological manifestations of Whipple's
disease are Dementia, disturbances of ocular
movement, abnormal involuntary movements,
particularly myoclonus, and deranged function of
the hypothalamus. Epilepsy, focal cerebral signs,
ataxia, and meningitic features may also be
present