Ayşe KARTAL, Serap TIRAŞ-TEBER, Erhan AKSOY, Gülhis DEDA, Aydan KANSU

Neurological findings spectrum in Celiac disease

Aksoy E, Tıraş-Teber S, Kansu A, Deda G. Kartal A. Neurologicalfindings spectrum in Celiac disease. Turk J Pediatr 2016; 58: 233-240.We aimed to provide early diagnosis by determining possible Celiac diseaserelated subclinical or symptomatic neurological abnormalities in children inorder to decrease risk of mortality and morbidity.Children with Celiac disease were assessed with neurological examination,neurophysiological tests and neuroimaging.A total of 65 patients were included in the study. The neurological examinationwas abnormal in 4 patients. There were EEG abnormalities in 5 patients, VEPwas abnormal in 7 patients, BAER was abnormal in 1 patient, ENMG wasabnormal in 8 patients, and there were abnormal findings on neuroimagingin 2 patients.The Celiac disease related neurological complications that manifest in adulthoodusually lay their foundations in childhood. Therefore, it must be kept in mindthat subclinical neurological abnormalities may be related to Celiac disease,and Celiac disease may be the underlying cause in the patients with overtneurological abnormalities in childhood.

PDF

___

1. Tovoli F, Masi C, Elena G, Guidetti E, Negrini P, Bolondi L. Clinical and diagnostic aspects of gluten related disorders. World J Clin Cases 2015; 3: 275-284.
2. Parisi P, Principessa L, Ferretti A, et al. “EEG abnormalities” may represent a confounding factor in celiac disease: A 4-year follow-up family report. Epilepsy Behav Case Rep 2014; 2: 40-42.
3. Steele R; CRF. Diagnosis and management of coeliac disease in children. Postgrad Med J 2011; 87: 19-25.
4. Hadjivassiliou M, Sanders DS, Grünewald RA, Woodroofe N, Boscolo S, Aeschlimann D. Gluten sensitivity: from gut to brain. Lancet Neurol 2010; 9: 318-330.
5. Grossman G. Neurological complications of coeliac disease: what is the evidence? Pract Neurol 2008; 8: 77–89
6. Bürk K, Farecki ML, Lamprecht G, et al. Neurological Symptoms in Patients with Biopsy Proven Celiac Disease. Mov Disord 2009; 24: 2358-2362.
7. Freeman HJ. Neurological disorders in adult celiac disease. Can J Gastroenterol 2008; 22: 909-911.
8. Cakir D, Tosun A, Polat M, et al. Subclinical neurological abnormalities in children with celiac disease receiving a gluten-free diet. J Pediatr Gastroenterol Nutr 2007; 45: 366-369.
9. Luostarinen L, Himanen SL, Luostarinen M, Collin P, Pirttila T. Neuromuscular and sensory disturbances in patients with well treated coeliac disease. J Neurol Neurosurg Psychiatry 2003; 74: 490-494.
10. Cooke WT, Smith WT. Neurological disorders associated with adult coeliac disease. Brain 1966; 89: 683-722.
11. Briani C, Zara G, Alaedini A, et al. Neurological complications of celiac disease and autoimmune mechanisms: a prospective study. J Neuroimmunol 2008; 195: 171-175.
12. Volta U, De Giorgio R, Petrolini N, et al. Clinical findings and anti-neuronal antibodies in coeliac disease with neurological disorders. Scand J Gastroenterol 2002; 37: 1276-1281.
13. Luostarinen L, Pirttilä T, Collin P. Coeliac disease presenting with neurological disorders. Eur Neurol 1999; 42: 132-135.
14. Chapman RW, Laidlow JM, Colin-Jones D, et al. Increased prevalence of epilepsy in coeliac disease. Br Med J 1978; 2: 250-251.
15. Parisi P, Pietropaoli N, Ferretti A, et al. Role of the gluten-free diet on neurological-EEG findings and sleep disordered breathing in children with celiac disease. Seizure 2015; 25: 181-183.
16. Mavroudi A, Karatza E, Papastavrou L, Panteliadis C, Spiroglou K. Succesful treatment of epilepsy and celiac disease with gluten free diet. Pediatr Neurol 2005; 33: 292-295.
17. Collin P, Pirttila T, Nurmikko T, Somer H, Erile T, Keyrilainen O. Celiac disease, brain atrophy and dementia. Neurology 1991; 41: 372-375.
18. Hu WT, Murray JA, Greenaway MC, Parisi JE, Josephs KA. Cognitive impairment and celiac disease. Arch Neurol 2006; 63: 1440-1446.
19. Volta U, Ferri GG, De Giorgio R, et al. Sensorineural hearing loss and celiac disease: a coincidental finding. Can J Gastroenterol 2009; 23: 531-535.
20. Yıldırım S.V, Tiker F, Barutcu O, Cengiz N. Bilateral calcifications in the basal ganglia, and frontal and parietal lobes of a patient with coeliac disease. Pediatr Radiol 2005; 35: 710-712.
21. Beyenburg S, Scheid B, Schluter MD, Lagrezee HL. Chronic Progressive Leukoencephalopathy in adult celiac disease. Neurology 1998; 50: 820-822.
22. Cervio E, Volta U, Verri M, et al. Sera from patients with celiac disease and neurologic disorders evoke a mitochondrial-dependent apoptosis in vitro. Gastroenterology 2007; 133: 195-206.