Neurological symptoms in patients with biopsy proven celiac disease.

Bürk K, Farecki ML, Lamprecht G, Roth G, Decker P, Weller M, Rammensee HG, Oertel W.
Department of Neurology, University of Marburg, Marburg, Germany.

In celiac disease (CD), the gut is the typical manifestation site but atypical neurological presentations are thought to occur in 6 to 10% with cerebellar ataxia being the most frequent symptom. Most studies in this field are focused on patients under primary neurological care. To exclude such an observation bias, patients with biopsy proven celiac disease were screened for neurological disease. A total of 72 patients with biopsy proven celiac disease (CD) (mean age 51 +/- 15 years, mean disease duration 8 +/- 11 years) were recruited through advertisements. All participants adhered to a gluten-free diet. Patients were interviewed following a standard questionnaire and examined clinically for neurological symptoms. Medical history revealed neurological disorders such as migraine (28%), carpal tunnel syndrome (20%), vestibular dysfunction (8%), seizures (6%), and myelitis (3%). Interestingly, 35% of patients with CD reported of a history of psychiatric disease including depression, personality changes, or even psychosis. Physical examination yielded stance and gait problems in about one third of patients that could be attributed to afferent ataxia in 26%, vestibular dysfunction in 6%, and cerebellar ataxia in 6%. Other motor features such as basal ganglia symptoms, pyramidal tract signs, tics, and myoclonus were infrequent. 35% of patients with CD showed deep sensory loss and reduced ankle reflexes in 14%. Gait disturbances in CD do not only result from cerebellar ataxia but also from proprioceptive or vestibular impairment. Neurological problems may even develop despite strict adherence to a gluten-free diet. (c) 2009 Movement Disorder Society.

PMID: 19845007 Oct 2009

Too bad it doesn't mention these conditions are also frequent in those with gluten sensitivity w/o celiac disease, or that for those who develop neurological disease despite a gluten free diet... that they may also need to be casein free, soy free, etc, depending upon the individual.

In many cases, these symptoms do improve on a gluten free diet (sometimes casein free, soy free, etc).

I think this paper is quite stunning, considering the higher percentages of those with celiac disease who have psychiatric illness, migraine, ataxia, and deep sensory loss. Not that it is news to me.

Oy! Need to find my medical dictionary and re-read that. I can say I had gut problems for years and then neurological issues joined the party for a few years before my gluten sensitive dx. I've been gluten free for 2.5 years now and the gut/ neuro issues are gone. Woohoo!!!

Exactly! I am not diagnosed celiac, yet I do have many pf those issues, including the migraines, ataxia, depression, personality changes, etc. I think these are not just a celiac issue, they are a gluten issue for not celiacs.

Not sure how long 24 yo daughter had "intolerance" to wheat/gluten/casein-cow milk. But was just recently found. Immunoglobulin A is high as well.
Not sure what this means. We are very new.
She has been told that she is presenting as someone with Celiac.

Now what? I have had her schedule an appt with an gastro for possibly the biopsy? But shouldn't there be more done? She is on the GFCF. So many questions. So much information!!