Celiac disease and epilepsy in pediatric patients

Abstract

Among 783 patients referred to our institute with different types of seizures as presenting symptom, systematic evaluation of antigliadin and antiendomysial antibodies in the serum has identified nine in whom jejunal biopsy has subsequently confirmed the diagnosis of celiac disease (CD). In three of them brain imaging showed the presence of calcified areas in the occipital region. They had complex partial seizures (CPS), associated in two with transient episodes of blindness. In another patient with CPS and generalized tonic-clonic seizures (GTCS) progressive multifocal cerebral calcifications were noted. In the other six patients with CPS and/or GTCS cerebral calcifications were absent. Symptoms of CD in all these cases were either not previously taken into account, or they were very mild or completely absent. In a group of 36 patients with clinically manifest CD, regular follow-up, and good compliance with the dietary regimen, no clinical seizures were reported. The pathogenetic mechanism and the relationship between epilepsy and an early diagnosis and treatment of celiac disease are discussed.

The neurology of coeliac disease in childhood: what is the evidence? A systematic review and meta‐analysis

“…Both studies of Fois et al 17 and Vascotto and Fois 18 found that the prevalence of the disease in children with epilepsy (0.8% and 1.1% respectively) was in agreement with the prevalence of the disease in the general population. Labate et al 22 screened children with childhood partial epilepsy both with and without occipital paroxysms, and recorded a prevalence of the disease as high as 2.7% among those with occipital paroxysms (0% for those without occipital paroxysms).…”

“…The characteristics of the 15 studies included in the review are summarized in Table I; four were comparative observational cohort prospective studies, [11][12][13][14] two were comparative observational case-control studies, 15,16 and eight were descriptive crosssectional studies. [17][18][19][20][21][22][23][24][25] The included studies involved 11 772 participants. The primary inclusion criteria entailed children (median age 10 years 6 months) with a diagnosis of coeliac disease.…”

Celiac Disease and Epilepsy: The Effect of Gluten-Free Diet on Seizure Control

“…Several studies have suggested an association between CD and epilepsy [10,11]. The prevalence of celiac cases in people with epilepsy ranges from approximately 0.8-6% [8,12].…”

The Neuroimmunology of Gluten Intolerance

“…A link between epilepsy and CD was proposed as far back as 1978 (Chapman et al, 1978;Fois et al, 1994;Cronin et al,1998). Whilst studies examining the prevalence of CD amongst patients with epilepsy have suggested a prevalence of 1.2-2.3%, others failed to demonstrate an increased prevalence (Ranua et al, 2005).…”