Bilateral occipital calcification, epilepsy and coeliac disease: clinical and neuroimaging features of a new syndrome.

Magaudda, Adriana; Bernardina, Bernardo Dalla; Marco, P. De; Sfaello, Z; Longo, Marcello; Colamaria, V.; Daniele, Ornella; Tortorella, Gaetano; Tata, Martha; Perri, R. Di

doi:10.1136/jnnp.56.8.885

Cited by 65 publications

(40 citation statements)

References 17 publications

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“…Neurological disorders described in association with CD include, among others, sporadic and progressive cerebellar ataxia, cerebral atrophy and dementia, cerebral vasculitis, myopathy, peripheral neuropathy and epilepsy 13 . During the last few decades, several screening studies on the prevalence of CD among epileptic patients [14][15][16] were published, and the existence of a syndrome, initially described by Gobbi et al 17 , characterized by the association of CD, epilepsy and occipital calcifications is, by now, well established and confirmed by several later series 18,19 and case reports 20,21 . Apparently the prevalence of CD among epileptic patients is increased although a chance association between epilepsy and CD can not be excluded, since the prevalence of asymptomatic CD in the general population, as previously cited, appears to be relatively high.…”

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confidence: 92%

Is the prevalence of celiac disease increased among epileptic patients?

Pratesi

Gandolfi

Martins³

et al. 2003

Arq. Neuro-Psiquiatr.

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-Objective: To assess the prevalence of celiac disease (CD) among a group of epileptic patients attending the Epilepsy Clinics of two general hospitals in the city of Brasilia (DF), Brazil. Method: Serum samples were collected from 255 epileptic patients (119 children, 136 adults) originating from Epilepsy Clinics, and from a control group composed by 4405 individuals (2034 children, 2371 adults) attending the Laboratory of Clinical Analysis, for routine blood testing. The diagnosis of CD was determined by the antiendomysium antibody (IgA-EMA) test and by small intestine biopsy. Results: two of the 255 epileptic patients (1:127) and fifteen subjects from the control group (1:293) tested positive for the IgA-EMA assay. Conclusion: the prevalence of CD was 2.3 times higher in epileptic patients than in controls (7.84 per 1000 versus 3.41 per 1000). Although still not statistically significant, this result is highly suggestive of an increased prevalence of CD among epileptic patients.KEY WORDS: celiac disease, gluten-sensitive enteropathy, epilepsy, prevalence A prevalência da doença celíaca é elevada entre pacientes com epilepsia? A prevalência da doença celíaca é elevada entre pacientes com epilepsia? A prevalência da doença celíaca é elevada entre pacientes com epilepsia? A prevalência da doença celíaca é elevada entre pacientes com epilepsia? A prevalência da doença celíaca é elevada entre pacientes com epilepsia? RESUMO -Objetivo: Determinar a prevalência da doença celíaca (DC) num grupo de pacientes epilépticos atendidos em ambulatórios de especialidade de dois hospitais gerais na cidade de Brasília (DF). Método: Amostras de soro foram colhidas de 255 pacientes epilépticos (119 crianças, 136 adultos) e de uma população formada por 4405 indivíduos (2034 crianças, 2371 adultos), atendidos no Laboratório de Análises Clínicas para exames de rotina. O diagnóstico de DC foi estabelecido por meio do teste de anticorpos antiendomísio (IgA-EMA) e por biópsia do intestino delgado. Resultados: dois dos 255 pacientes epilépticos (1:127) e quinze indivíduos do grupo controle (1:293) apresentaram biópsia compatível e resultados positivos no teste IgA-EMA. Conclusão: a prevalência de DC foi 2.3 vezes maior em pacientes epilépticos do que nos controles (7.84 per 1000 versus 3.41 per 1000). Apesar deste resultado não ser estatisticamente significativo pode, no entanto ser considerado altamente sugestivo da existência de prevalência aumentada de DC entre pacientes epilépticos. PALAVRAS-CHAVE: doença celíaca, enteropatia sensível ao glúten, epilepsia, prevalência.Celiac disease (CD), also known as gluten-sensitive enteropathy, is a lifelong disorder of variable severity characterized by malabsorption and specific, though not pathognomonic, lesions of the small intestinal mucosa. Mucosal lesions are occasioned by sensitivity to ingested wheat gluten or related barley or rye proteins in genetically susceptible individuals. A strict gluten free diet (GFD) results in regression of the small intestinal abnormalities and a r...

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mentioning

confidence: 92%

Is the prevalence of celiac disease increased among epileptic patients?

Pratesi

Gandolfi

Martins³

et al. 2003

Arq. Neuro-Psiquiatr.

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“…The epilepsy prevalence among CD patients is reported as 1.2-5% (13). On the other hand, the prevalence of CD among patients with epilepsy is reported to be around 3% to 6% (14,15). Furthermore, Labate et al (16) have reported that as high as 8% of CPEO patients have CD.…”

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confidence: 99%

Celiac Disease and Associated Neurological Conditions

IŞIKAY¹,

HIZLI²

2015

Turkish J Pediatr Dis

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Objective: Celiac disease has been associated with many neurological disorders. In this report, we discuss 16 patients with both celiac disease and neurological symptoms and evaluate the overall neurological features of celiac disease in the light of the current literature to emphasize the neurological aspects of celiac disease. Material and Methods:The medical records of all patients diagnosed with celiac disease between 2010 and 2012 were reviewed.Results: Nine of these 16 cases were female while seven were male with a mean age of 10.34±3.76 years (5-16 years). The reported neurological problems of these 16 children with celiac disease were epilepsy (n=10), mental retardation (n=9), ataxia (n=3), neuropathy (n=1), headache (n=2), febrile seizure (n=1), and neurofi bromatosis type 1 (plus headache) (n=1). Conclusion:Celiac disease may accompany many different neurological conditions. These disorders can share some symptoms such as associated anemia, short stature, and chronic gastrointestinal complaints and the diagnosis of celiac disease may be delayed among patients with neurological disease.

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“…In a case report of a 4-yearold patient presenting with epileptic seizures, Lea et al (2) documented the progressive appearance of bilateral parietal intracranial calcifications and a subsequent diagnosis of celiac disease, which resulted in adequate seizure control without the need for medication after instituting dietary changes. The description of the triad of bilateral parietal calcifications, epilepsy and celiac disease is already widely reported in the literature (3)(4)(5)(6)(7)(8)(9)(10) . Pfaender et al (4) reported the cases of three patients whose initial symptoms of disease were the occurrence of various visual symptoms, which were sometimes followed by significant headaches/migraines and the identification of bilateral parietal intracranial calcifications, with a subsequent diagnosis of celiac disease.…”

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confidence: 99%

“…Post-mortem analysis of brain tissue from some patients drives the suspicions that immune-mediated phenomena may alter the cerebral vascular permeability, favoring the localized deposition of calcium (3,6) .…”

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confidence: 99%

Baixa acuidade visual secundária à doença celíaca

Martins

Costa

2012

Einstein (São Paulo)

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Cranial computed tomography showing posterior cortical-subcortical calcifications in the occipital and occipitoparietal regionsThe male patient was a 24-year-old student who was a native of São Paulo (SP). The onset of left hemibody numbness associated with decreased strength and difficulty speaking was 15 days ago. It progressed with decreased bilateral visual acuity. After 90 minutes, the patient presented with photophobia and severe holocranial headaches, which were unresponsive to common analgesics. The headaches improved after analgesic medication, but the visual change persisted. For his past medical history, the patient has had recurrent episodes of "sparkles" in his vision that progressed to headaches since he was 12 years of age. He was evaluated by a neurologist at that time and showed changes in the central nervous system, but no specific diagnosis was indicated. The patient reported the occurrence of four additional episodes over the past year that were similar to the current episode, although the intensity of the headaches was lower. In his family history, there have been cases of migraine headaches. Since the last episode, the patient has been taking valproic acid and dexamethasone. An ophthalmologic examination showed a best-corrected

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Bilateral occipital calcification, epilepsy and coeliac disease: clinical and neuroimaging features of a new syndrome.

Abstract: Twenty patients affected by bilateral occipital cortical-subcortical calcification (BOC) are described, 19 (95%)

Cited by 65 publications

References 17 publications

Is the prevalence of celiac disease increased among epileptic patients?

Is the prevalence of celiac disease increased among epileptic patients?

Celiac Disease and Associated Neurological Conditions

Baixa acuidade visual secundária à doença celíaca

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