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Celiac Disease and Neurologic Disorders

Among the most common neurology problems associated with celiac disease are peripheral neuropathy, cerebellar ataxia, epilepsy, multiple sclerosis and migraine. In a recent study of 26 patients with CD, 31% had abnormalities in neurophysiologic studies, compared with 4% of controls with reflux disease.

Nutritional factors have been suspected in association with neurological defects but are rarely found and their correction does not seem to influence in the prognosis. Some reports show certain neurologic symptoms that respond to a GFD, especially if it is started in the fi rst few months after their appearance. It is now evident that the link between celiac disease and neurologic disorders results, in part, from common genetic background, most importantly, the HLA region on chromosome 6, and other markers.

In addition to genetic predisposition, immunologic factors probably also play a role. One way that this may occur is by antibody or T-cell cross-reactivity, a mechanism that is suspected of triggering the immune response in some autoimmune diseases.

Alternatively, it may result from the involvement of additional autoantigens through epitope spreading. The gluten-free diet effect on epilepsy control has been variable. In most patients, some beneficial effects have been reported such as better seizure control and a decrease in dosing of anti-epileptic medications, but without achieving a complete resolution of seizures with the diet alone.

†Depression and other psychiatric symptoms have been reported as common complications of CD, occurring in about one third of patients. Common symptoms include apathy, excessive anxiety and irritability. All of them clearly improve after few months of adherence to a GFD.

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