Neurological manifestations of celiac disease

Arquivos de Neuro-Psiquiatria

José Ibiapina Siqueira Neto²  Ana Carolina Leite Vieira Costa²  Francisco George Magalhães¹  Gisele Sampaio Silva¹ 

[1] ,Federal University of Ceará Department of Internal Medicine Fortaleza CE ,Brazil

关键词: celiac disease;    cerebellar ataxia;    epilepsy;    cognitive impairment;    doença celíaca;    ataxia cerebelar;    epilepsia;   

DOI  :  10.1590/S0004-282X2004000600007

来源: SciELO

【 摘 要 】

Celiac disease (CD/ Nontropicalsprue, gluten-sensitive enteropathy) is a malabsortive condition in which an allergic reaction to the cereal grain-protein gluten (present in wheat, rye and barley) causes small intestine mucosal injury. The onset is in the first four decades of life, with a female to male ratio of 2:1. It may be associated with a wide spectrum of neurological manifestations including cerebellar ataxia, epileptic seizures, dementia, neuropathy, myopathy and multifocal leucoencephalopathy. We report three patients with neurological manifestations related with CD: one with cerebellar ataxia, one with epilepsy and one with cognitive impairment. The diagnosis of CD was confirmed by serologic tests (antiendomysial and antigliadin antibodies) and biopsy of the small intestine. In two patients the neurological symptoms preceded the gastrointestinal abnormalities and in all of them gluten restriction failed to improve the neurological disability. Conclusion: CD should be ruled out in the differential diagnosis of neurological dysfunction of unknown cause, including ataxia, epilepsy and dementia. A gluten free diet, the mainstay of treatment, failed to improve the neurological disability.

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