Forecasting for the diagnosis of carpal tunnel syndrome

Abstract

Background: Celiac disease (CD) is an auto-immune disorder characterized by gluten hypersensitivity and presence of antitransglutaminase and anti-gliadin antibodies. Clinical manifestations, mainly digestive, are various but neurological involvement is rare. Aim of the study: To describe clinical, para clinical and outcome parameters in patients presenting neurological manifestations of CD. Patients and methods: A retrospective study, including patients followed for CD with neurological involvement at the neurology department in Sfax, Tunisia, since its creation in 1991. Results: Three women and a man were included in this study. Mean age of neurological symptoms onset was 20 years (7 to 36 years). Neurological manifestations were inaugural in one case. One patient presented peripheral nerve damage and central nervous system (CNS) was found in 3 patients (cerebellar ataxia, seizures and cerebral venous thrombosis). All patients received a gluten-free diet with a favourable outcome. Discussion / Conclusion: Neurological complications of CD are but various. They may be revealing a CD in adults. They affect either central or peripheral nervous system. Peripheral neuropathy and white matter abnormalities are the most common paraclinic findings. The use of brain imaging or electromyography, guided by clinical assessment, is highly recommended in patients with CD, as well as a strict follow up and observation of a gluten-free diet.