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

Abstract

METHOD We conducted a review of paediatric studies published in English assessing neurological illness in coeliac disease identified through a MEDLINE search ). Calculation of computed relative risk, odds ratio, and risk difference was performed using the fixed effect method if applicable.RESULTS Fifteen studies were analysed (11 772 participants). The meta-analysis showed that (1) the relative risk of epilepsy in individuals with coeliac disease, and of coeliac disease in individuals with epilepsy, compared with the general population, was 2.1 and 1.7, respectively, and the risk difference was close to zero, indicating that it was probably a chance association; and (2) the relative risk of headache in individuals with the disease compared with comparison groups was 3.2. In two studies, cerebellar ataxia was documented in 2.7 to 5.4% of participants; in two further studies, the risk of cerebellar dysfunction was zero. Two studies found an association between coeliac disease and peripheral neuropathy. Brain white matter lesions were recorded in two other studies. An association between autism and coeliac disease is disputed.

An overview of coeliac disease: patterns, causes, symptoms and management

“…It is also found at an increased rate in people with other auto-immune disorders, particularly type 1 diabetes mellitus (Triolo et al 2011) and in a variety of neurological conditions (Lionette et al 2010) .…”

A surprising cause of motor tics

“…Neurological presentations are also possible, sometimes in the absence of gastrointestinal symptoms. Neurological symptoms reported in CD include hypotonia, developmental delay, seizure disorders, learning disorders, ADHD, headache, cerebellar ataxia, peripheral neuropathy and rarely, tics (2,3). A study of approximately 300 children noted that 50% of children with CD had neurological symptoms, compared with 20% of controls (2).…”

Neuropsychiatric Features of Celiac Disease

“…A meta-analysis of 15 studies [59] found a 2.1-fold increased risk of epilepsy in children with CD. However, recent data are less consistent and vary below these figures due to operational definitions of epilepsy [60].…”

“…Zelnik et al [32] found that headache was the most common neurologic disorder (27.9%) in a group of 111 CD patients. A meta-analysis of 15 studies [59] found a 3.2-fold increase risk of headache in children with CD. Adherence to a gluten-free diet has been shown to have favorable outcomes on headache symptoms reported in CD [32,49,63].…”