Quote:
Feb 2009
Hippocampal sclerosis in refractory temporal lobe epilepsy is associated with gluten sensitivity.
Medical school, University of Tampere, Finland.
Previously coeliac disease (CD) and gluten sensitivity (defined as the presence of anti-gliadin antibodies and positive immunogenetics) has been associated with cerebellar degeneration and epilepsy with occipital calcifications. Hippocampal sclerosis (HS) in temporal lobe epilepsy (TLE) is a potentially progressive disorder with unknown aetiology, and autoimmunity has been implicated in TLE+HS as one of the possible mechanism leading to HS.The purpose of this study is to analyze CD associated antibodies and gluten sensitivity in well characterized group of patients with refractory focal epilepsy. We measured anti-gliadin, anti-tTG and anti-EMA and celiac type HLA (DQ2 and DQ8) in 48 consecutive patients with therapy resistant localisation-related epilepsy. The patients were categorised TLE+HS (N=16), TLE-HS (N=16) and extratemporal epilepsy (N=16) based on ictal eletro-clinical characteristics and high resolution MRI. Patients with suspected CD or gluten sensitivity underwent duodenal biopsies. Seven patients were gluten sensitive, all of these patients had TLE+HS whereas none of the patients without HS were gluten sensitive (p< 0.0002). In duodenal biopsies three of the patients had histological evidence of CD and four had inflammatory changes consistent with early developing CD without villous atrophy. Four of the patients with gluten sensitivity had evidence of dual pathology (HS + another brain lesion) whereas none of the rest of patients did (p< 0.0002). The present study demonstrates a previously unrecognized association between gluten sensitivity and TLE with hippocampal sclerosis. The association was very robust in this well characterised group of patients; thus gluten sensitivity should be added to the list of potential mechanism leading to intractable epilepsy and HS.
PMID: 19244266
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Gluten is the protein found in wheat, barely, and rye. Celiac disease is an autoimmune disease that occurs in those with an adverse immunological response to gluten when autoantibodies form and attack the intestinal villi. Neurological problems, including seizures, have been associated with celiac disease for decades. However because celiac disease is a GI disease, and used to be considered rare (its not, its common)... it has not been on the radar screens of neurologists.
This study is really significant because it is one of the first to broaden the search to include gluten sensitivity that isn't celiac disease. It is only in the last decade that researchers have begun to show that gluten sensitivity can cause neurological and other disease without showing as "celiac disease". I've been posting about this most of that time.
I honestly believe that every new seizure patient, of any type, should be screened for antigliadin antibodies associated with gluten sensitivity. And, because this has not been on the radar screen for neurologists, "old" seizure patients should also follow up on this...particularly if there is any family history of autoimmune disease or GI problems. Gluten has been implicated
in many different seizure types, and frankly, they haven't looked enough. Kudos to those who put together this study.
BTW... if gluten sensitivity IS the underlying factor in seizures, in some cases a gluten free diet alone is enough to resolve the seizures...if instituted before permanent damage is done.
For more info on gluten sensitivity/ celiac disease see The Gluten File:
http://jccglutenfree.googlepages.com/seizuresepilepsy
Cara