Neurologic Manifestations of Hepatic and Gastrointestinal Disease

Hepatic encephalopathy has different clinical presentations and management depending on whether it is due to acute or chronic liver disease. Rare complications of chronic liver disease include hepatic myelopathy and acquired hepatocellular degeneration. Gastrointestinal disorders and bariatric surgery can cause malabsorption, leading to vitamin and mineral deficiencies that can present as neurologic disorders such as neuropathy, myelopathy, and neuropsychiatric symptoms. Celiac disease can cause neurologic symptoms such as ataxia without associated gastrointestinal symptoms and should therefore be considered in the differential diagnosis of ataxia. Inflammatory bowel disease increases the risk of thrombotic events, and treatment of inflammatory bowel disease with tumor necrosis factor-α inhibitor therapy can cause central and peripheral nervous system inflammatory complications.