Neurological complications of enteric disease.

Wills, Adrian; Hovell, C.

doi:10.1136/gut.39.4.501

Cited by 38 publications

(32 citation statements)

References 59 publications

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“…In the present series, 12 % of CD patients had neurological disorders that could not be attributed to any other cause but the intestinal condition. The documented frequency is in accordance with other reports [13,14]. Being a retrospective study, it lacks case or population control comparisons negating the ability to estimate the prevalence of the neurological disorders in celiac disease.…”

Section: Discussionsupporting

confidence: 85%

“…Anecdotal reports of neurological abnormalities include peripheral neuropathy, neuromuscular disorders, myelopathy, multifocal leukoencephalopathy, dementia, seizures, progressive myoclonic ataxia and cerebellar ataxia [6][7][8][9][10][11][12].While there is a crude estimation that about 6-10 % of CD patients suffer from neurological disorders [13,14], the spectrum and prevalence of the neurological involvement have only recently been addressed [14]. We therefore examined retrospectively the occurrence and spectrum of neurological abnormalities in CD patients diagnosed in our institute during a 20 year period.…”

Section: Introductionmentioning

confidence: 99%

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Neurological abnormalities associated with celiac disease

Vaknin

Eliakim

Ackerman³

et al. 2004

J Neurol

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Section: Discussionsupporting

confidence: 85%

Section: Introductionmentioning

confidence: 99%

Neurological abnormalities associated with celiac disease

Vaknin

Eliakim

Ackerman³

et al. 2004

J Neurol

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“…[7][8][9] Additional complications such as cerebellar ataxia or peripheral neuropathy are very rare in childhood. 9,10,14 In our study, we found 2 patients with mild ataxia (0.03%) and 6 with seizures (0.08%), but these seizures were in 3 instances of anamnestic febrile seizures and 1 of typical absence epilepsy, unlikely to be linked to CD. Occipital calcifications were not observed.…”

Section: Discussionmentioning

confidence: 99%

Brain White-Matter Lesions in Celiac Disease: A Prospective Study of 75 Diet-Treated Patients

et al. 2001

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ABSTRACT. Objective. Celiac disease (CD), or gluten sensitivity, is considered to be a state of heightened immunologic responsiveness to ingested gluten proteins in genetically predisposed individuals. The gastrointestinal manifestation suggests a severe enteropathy of the small intestine with malabsorption, steatorrhea, and weight loss because of a deranged mucosal immune response. Neurologic complications occur, especially epilepsy, possibly associated with occipital calcifications or folate deficiency and cerebellar ataxia. There have been reports of brain white-matter lesions as an extraintestinal manifestation in Crohn disease and ulcerative colitis but not in CD.Methods. In this study, 75 diet-treated mainly pediatric patients with biopsy-proven CD underwent prospectively clinical neurologic examinations, laboratory investigations, electroencephalography, computed tomography, and magnetic resonance imaging. The age range was 2.8 to 24.2 years with a mean of 11.6 years. The mean period of gluten exposure was 2.4 years.Results. Ten patients had neurologic findings such as febrile seizures, single generalized seizures, mild ataxia, and muscular hypotonia with retarded motor development. No folate deficiency was found. The hippocampal regions showed no abnormalities. Computed tomography did not reveal any cerebral calcifications, but magnetic resonance imaging detected unilateral and bilateral T2-hyperintensive white-matter lesions in 15 patients (20%). There was no correlation between these lesions and dietary compliance or neurologic or electroencephalographic abnormalities. The mean gluten exposure time of these patients was slightly increased (not significant).Conclusions. Focal white-matter lesions in the brain may represent an extraintestinal manifestation of CD. They may be ischemic in origin as a result of a vasculitis or caused by inflammatory demyelination. They seem to be more typical of pediatric CD than cerebral calcifications. Their prognostic value is unclear and needs to be elucidated in additional studies. CD should be suggested as a differential diagnosis in children with unclear white-matter lesions even without intestinal symptoms. Pediatrics 2001;108(2). URL: http://www.pediatrics.org/ cgi/content/full/108/2/e21; celiac disease, neurologic complications, brain white-matter lesions, child.ABBREVIATIONS. CD, celiac disease; EEG, electroencephalography; CT, computed tomography; MRI, magnetic resonance imaging; AU, arbitrary units. C eliac disease (CD), or gluten sensitivity, is considered to be a state of heightened immunologic responsiveness to ingested gluten proteins in genetically predisposed individuals. The gastrointestinal manifestation implies a severe enteropathy of the small intestine with malabsorption, steatorrhea, and weight loss associated with characteristic lesions of the small bowel mucosa, which improve after withdrawal of gluten from the diet. It often is associated with the presence of antiendomysial and antigliadin antibodies. The pathologic mucosal immune response has a ...

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“…Neurological complications are estimated to occur in 6%-10% of patients with celiac disease (22,34,40,46,48) . Numerous cases have already been described of gluten-sensitive patients with a high proportion of neurological symptoms of unknown origin, including cerebellar ataxia, peripheral neuropathy, multifocal encephalopathy, epilepsy, dementia, neuromyelitis optica, muscular hypotonia and delayed motor development (18,22,25,26,28,34,40,46,48,53,55) . Some studies published in the literature have attempted to demonstrate an association between celiac disease and epilepsy (4,7,8,11,12,13,18,30,32,35,42,43,44) .…”

Section: Introductionmentioning

confidence: 99%

Prevalence of Celiac Disease in Children With Epilepsy

Vieira

Jatobá

Matos

et al. 2013

Arq. Gastroenterol.

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-Context -Neurological symptoms have been well-documented in patients with celiac disease, nevertheless, the presumption of a greater prevalence of epilepsy in celiac patients remains controversial. Objectives -To determine the frequency of celiac disease in children and adolescents with idiopathic or cryptogenic epilepsy. Methods -A cross-sectional study. One hundred pediatric patients with non-symptomatic epilepsy were followed-up at two public pediatric neurology clinics in Salvador, Bahia, Brazil. Screening for celiac disease was performed by serial measurements of IgA anti-transglutaminase and IgA anti-endomysium antibodies, followed by bowel biopsy in positive cases. HLA DQ02 and DQ08 were investigated in seropositive individuals, assessing the type of seizures, the number of antiepileptic drugs used and the presence gastrointestinal symptoms. Results -Three (3.0%) patients tested anti-tTG-positive, two with normal duodenal mucosa (Marsh 0) and one with intraepithelial infiltrate (Marsh I). No villous atrophy of the duodenal mucosa (Marsh III) celiac disease was found. Two patients tested positive for HLA DQ02; none were DQ08 positive.Conclusion -The present study failed to prove the association between celiac disease and epilepsy. HEADINGS -Celiac disease. Epilepsy. Disabled children.

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Neurological complications of enteric disease.

Cited by 38 publications

References 59 publications

Neurological abnormalities associated with celiac disease

Neurological abnormalities associated with celiac disease

Brain White-Matter Lesions in Celiac Disease: A Prospective Study of 75 Diet-Treated Patients

Prevalence of Celiac Disease in Children With Epilepsy

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