Gluten sensitivity and epilepsy: a systematic review

Julian, Thomas; Hadjivassiliou, Marios; Zis, Panagiotis

doi:10.1007/s00415-018-9025-2

Cited by 33 publications

(32 citation statements)

References 81 publications

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“…By contrast, all three patients with headache and occipital calcifications were children, of which two also had epilepsy. Cerebral calcifications in the context of CD have been associated with epilepsy [ 3 ], which is most commonly known as “epilepsy and cerebral calcification (CEC) syndrome”. However, although the available evidence is limited, there are cases with calcifications and migraine-like headaches in the absence of epilepsy.…”

Section: Resultsmentioning

confidence: 99%

“…Coeliac disease (CD) is the best-recognised GRD and it is characterized by a small bowel enteropathy occurring in genetically susceptible individuals whilst exposed to the protein gliadin [ 1 ]. Non-coeliac gluten sensitivity (NCGS) is a term that is used by gastroenterologists to describe patients with primarily gastrointestinal (GI) symptoms that are related to the ingestion of wheat, barley, and rye, who do not have enteropathy, but do symptomatically benefit from a gluten free diet (GFD) [ 2 ] However, in the context of neurological manifestations, patients might have serological evidence of gluten sensitivity (GS); usually anti-gliadin IgG and/or IgA (AGA), with or without transglutaminase (TG) or endomysial antibodies (EMA), but no histological changes on biopsy of the bowel to suggest CD [ 3 ]. Such patients might still benefit neurologically from a strict GFD.…”

Section: Introductionmentioning

confidence: 99%

“…Although the gastrointestinal manifestations of GRDs are the most prevalent, a range of debilitating neurological manifestations are increasingly being recognised in clinical practice, often preceding or in the absence of GI symptoms. The most well-known neurological GRDs are cerebellar ataxia [ 4 ] and peripheral neuropathy [ 5 ], however clear links between GS/CD and epilepsy [ 3 ], various movement disorders [ 6 ], and headaches [ 7 ] have also been described.…”

Section: Introductionmentioning

confidence: 99%

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Headache Associated with Coeliac Disease: A Systematic Review and Meta-Analysis

2018

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Objective: The aim of this systematic review was to explore the relationship between coeliac disease (CD) and headache. The objectives were to establish the prevalence of each entity amongst the other, to explore the role of gluten free diet (GFD), and to describe the imaging findings in those affected by headaches associated with CD. Methodology: A systematic computer-based literature search was conducted on the PubMed database. Information regarding study type, population size, the age group included, prevalence of CD amongst those with headache and vice versa, imaging results, the nature of headache, and response to GFD. Results: In total, 40 articles published between 1987 and 2017 qualified for inclusion in this review. The mean pooled prevalence of headache amongst those with CD was 26% (95% CI 19.5–33.9%) in adult populations and 18.3% (95% CI 10.4–30.2%) in paediatric populations. The headaches are most often migraine-like. In children with idiopathic headache, the prevalence of CD is 2.4% (95% CI 1.5–3.7%), whereas data for adult populations is presently unavailable. Brain imaging can be normal, although, cerebral calcifications on CT, white matter abnormalities on MRI and deranged regional cerebral blood flow on SPECT can be present. GFD appears to be an effective management for headache in the context of CD, leading to total resolution of headaches in up to 75% of patients. Conclusions: There is an increased prevalence of CD amongst idiopathic headache and vice versa. Therefore, patients with headache of unknown origin should be screened for CD, as such patients may symptomatically benefit from a GFD.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Headache Associated with Coeliac Disease: A Systematic Review and Meta-Analysis

2018

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“…Coeliac disease has been linked to epilepsy. CD is two times more prevalent in epilepsy patients compared to the general population and epilepsy is 1.8 times more prevalent in CD [40]. In some pediatric cases, occipital calcifications can be identified on brain imaging.…”

Section: Epilepsy and Gluten Sensitivitymentioning

confidence: 99%

The Neuropathology of Gluten-Related Neurological Disorders: A Systematic Review

et al. 2020

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Gluten-related neurological disorders (GRND) represent a spectrum of neurological manifestations that are triggered by gluten. In coeliac disease, a T-cell mediated enteropathy is triggered by gluten in genetically predisposed individuals. The underlying pathological mechanism of the neurological dysfunction is not yet clear. The aim of this review is to collate existing neuropathological findings in GRND as a means of aiding the understanding of the pathophysiology. A systematic search of the Pubmed Database yielded 188 articles, of which 32 were included, containing 98 eligible cases with a description of pathological findings in GRND. In gluten ataxia, loss of Purkinje cells, atrophy, gliosis and astrocytosis were apparent, as well as diffuse lymphocytic infiltration and perivascular cuffing with lymphocytes. In patients with large-fiber neuropathy, nerve biopsies revealed axonopathy, loss of myelinated fibers and focal and perivascular infiltration by inflammatory cells. Inflammatory infiltrate was also observed in muscle in myopathy and in cerebrum of patients with encephalopathy and patients with epilepsy. Such changes were not seen in skin biopsies from patients with small fiber neuropathies. The findings from this systematic review suggest an immune mediated pathogenesis for GRND. Future research should focus on the characterization of the inflammatory cell infiltrates and identifying target epitopes.

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“…NCWS is characterized by a series of intestinal and extraintestinal manifestations; the best studied of these are probably neurological disorders, which have been identiied as "wheat or gluten-dependent" [13,14], but many other symptoms have been reported to be part of the NCWS spectrum, despite the lack of speciically designed studies. In our study, we prospectively included patients with NCWS diagnosed using the current clinical gold standard, the DBPC wheat challenge, and, for the irst time, evaluated the frequency of gynecological and obstetric disorders associated with the NCWS condition.…”

Section: Discussionmentioning

confidence: 99%

Gynecological Disorders in Patients with Non-celiac Wheat Sensitivity

Soresi

Incandela²,

Mansueto

et al. 2020

Dig Dis Sci

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Gluten sensitivity and epilepsy: a systematic review

Abstract: Patients with epilepsy of unknown aetiology should be investigated for serological markers of gluten sensitivity as such patients may benefit from a GFD.

Cited by 33 publications

References 81 publications

Headache Associated with Coeliac Disease: A Systematic Review and Meta-Analysis

Headache Associated with Coeliac Disease: A Systematic Review and Meta-Analysis

The Neuropathology of Gluten-Related Neurological Disorders: A Systematic Review

Gynecological Disorders in Patients with Non-celiac Wheat Sensitivity

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