{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T23:56:34Z","timestamp":1781654194645,"version":"3.54.5"},"reference-count":13,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T00:00:00Z","timestamp":1777507200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T00:00:00Z","timestamp":1781654400000},"content-version":"vor","delay-in-days":48,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Neurol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Tumor necrosis factor-alpha (TNF-\u03b1) inhibitors are widely used for immune-mediated inflammatory diseases, including Crohn\u2019s disease. Although generally effective, TNF-\u03b1 blockade has been linked to uncommon but clinically significant paradoxical immune-mediated neurologic adverse events, including inflammatory demyelinating disorders of the central nervous system (CNS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>A 32-year-old woman with Crohn\u2019s disease (perianal fistula) treated with infliximab for one year presented with progressive dizziness, headache, and bilateral lower-limb weakness. Neurologic examination demonstrated ataxic gait, intention tremor, dysarthria, brisk reflexes (right-predominant), and a positive right Babinski sign, with preserved sensation. Initial laboratory testing and head CT were unremarkable. Brain MRI revealed multiple multifocal T2\/FLAIR hyperintense lesions involving bilateral periventricular and deep white matter, with plaques affecting the thalami, internal capsule, corpus callosum, cerebellum, and cerebellar peduncles; spinal MRI showed no active lesions. Cerebrospinal fluid studies were normal; infectious testing and autoimmune screening were negative, and oligoclonal bands and serum aquaporin-4 antibodies were negative. Infliximab was discontinued, and high-dose pulse corticosteroids were administered, resulting in mild symptomatic improvement; however, ataxia and dysarthria persisted. At three months, follow-up MRI showed stable lesions without radiologic activity alongside slow clinical improvement with rehabilitation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This case highlights a clinically significant, infliximab-associated CNS demyelinating syndrome with an MS-like radiologic pattern in a patient without prior neurologic history. Prompt recognition, discontinuation of the suspected agent, and early immunotherapy are essential; nonetheless, incomplete recovery may occur, underscoring the need for careful neurologic vigilance in patients receiving anti-TNF therapy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12883-026-04932-3","type":"journal-article","created":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T01:04:41Z","timestamp":1777511081000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Infliximab-associated multifocal central nervous system demyelination mimicking multiple sclerosis in a patient with Crohn\u2019s disease: a case report"],"prefix":"10.1186","volume":"26","author":[{"given":"Mohammad Ahmad","family":"Sawaftah","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed","family":"AbuBaha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bara","family":"AbuBaha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muthanna","family":"Shoman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad","family":"muneeb izzat Abbas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,4,30]]},"reference":[{"issue":"1","key":"4932_CR1","doi-asserted-by":"publisher","first-page":"e002924","DOI":"10.1136\/rmdopen-2022-002924","volume":"9","author":"B Delcoigne","year":"2023","unstructured":"Delcoigne B, Kopp TI, Arkema EV, Hellgren K, Provan SA, Relas H, et al. 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A copy of the written consent is available for review by the Editor-in-Chief of this journal on request.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent was obtained from the patient for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal upon request.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"392"}}