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Complex partial status epilepticus in a patient with Crohn's disease
Montserrat G Delgado1, Juan Vega, Elena Santamarta
1Neurology Service, Asturias Central University Hospital, Spain.
BMJ Case Reports
|September 10, 2013
Summary
This case study highlights a rare complication of Crohn's disease: meningitis and epidural abscess. Prompt diagnosis and intervention are crucial for managing this severe neurological manifestation in Crohn's patients.
Area of Science:
- Neurology
- Gastroenterology
- Infectious Diseases
Background:
- Crohn's disease is a chronic inflammatory bowel condition.
- Neurological complications, such as meningitis and epidural abscess, are rare in Crohn's disease.
- This case explores a severe presentation of Crohn's disease with neurological sequelae.
Observation:
- A 42-year-old female with a history of Crohn's disease presented with sepsis.
- She subsequently developed confusion, Wernicke's disease, fever, aphasia, paraparesis, and status epilepticus.
- Diagnostic imaging revealed a presacral collection extending to the lumbosacral spine, confirming a lumbar epidural abscess.
Findings:
- Cerebrospinal fluid analysis showed elevated leukocytes and proteins.
- Abdominopelvic CT identified a presacral collection.
- Lumbar MRI confirmed a lumbar epidural abscess secondary to presacral abscess fistulization.
Implications:
- This case underscores the importance of considering rare neurological complications in Crohn's disease patients.
- Early recognition and management of spinal epidural abscesses are critical.
- Further research into the mechanisms linking Crohn's disease to such complications is warranted.
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