| There is reasonable evidence of neurological problems | | | | (think UFO) are white spots that show up on images |
| in Celiac disease (CD) even those well treated on a | | | | of the brain. When found in certain locations of the |
| gluten-free diet should undergo periodic neurological | | | | brain they are highly suggestive of multiple sclerosis |
| screening. Peripheral neuropathy is found in almost | | | | (multiple scarring spots in the brain). However, though |
| half of people with CD. Previously, neurological | | | | many people with CD have MS like symptoms and |
| complications in Celiac disease were reported to be | | | | these symptoms often respond to a gluten free diet |
| as high as 36% or more than a third. Some | | | | when started early enough, the UBO's seen on MRI |
| unexplained neurological problems are present but not | | | | of the brain are typically not in the classic areas of |
| recognized by the patient or their doctor in many | | | | MS. Instead it is common to find them in areas of |
| patients and some have several problems. | | | | the brain associated with migraines or balance |
| Unfortunately, since brain imaging is not routinely | | | | difficulty (ataxia). |
| done or recommended in those who are newly | | | | Some are seen in children associated with strange |
| diagnosed we don't really know how high these | | | | seizure problems even without obvious intestinal |
| numbers may be really be. More staggering is the | | | | symptoms. A classic specific syndrome is very well |
| fact that we are still learning about people who fail to | | | | recognized associated with epilepsy in both children |
| meet diagnostic criteria for Celiac disease but are | | | | and adults who have calcifications in their brain that |
| being found to have gluten related neurological | | | | can be detected by CT scan or MRI. Epilepsy is well |
| problems that respond to a gluten-free diet. | | | | documented but the studies are confusing enough |
| There are many neurological problems that in | | | | that there is not a good consensus regarding the risk |
| undiagnosed and untreated Celiac disease but include | | | | and recommended screening of all children with |
| neuropathy, balance problems (ataxia), seizures, | | | | epilepsy. |
| MS-like symptoms, headaches, memory impairment, | | | | Personally and professionally I have observed all of |
| depression and anxiety, inattention (ADD/ADHD), | | | | the neurological complications of Celiac disease and |
| schizophrenia, dementia, muscle weakness, childhood | | | | most of them I have also noted in patients in whom |
| developmental delay, autism (Asperger's). The sad | | | | I have not been able to confirm CD but who have |
| truth is that many patients have delays in diagnosis | | | | what I believe are objective signs and/or genetic risk |
| that result in delayed treatment and poor response | | | | for gluten sensitivity. I have patients with MS-like |
| even while adopting a strict gluten free diet. The | | | | symptoms, chronic unexplained neuropathy, |
| average delay of diagnosis in adults is between | | | | headaches, attention difficulties, autistic behaviors and |
| eleven and thirteen years. Dr. Hadjivassiliou, a | | | | developmental delays who have responded to |
| neurologist in England who is considered the world's | | | | gluten-free diet but if they had listened to doctors |
| expert in gluten related neurological problems has | | | | who maintained such a "restrictive, expensive, hard |
| communicated to me by e-mail and written that | | | | to follow" diet should only be "imposed" on those |
| responses to a gluten-free diet may take five years | | | | with a established diagnosis of Celiac disease. |
| and if the neurological condition has been longstanding | | | | If you have neurological problems get testing for |
| complete recovery is not likely. | | | | Celiac disease before starting a gluten-free diet. If |
| The symptoms of neuropathy are paresthesia | | | | you test negative for CD, make sure they test you |
| (numbness) or dysthesia (burning, tingling, heaviness, | | | | for the complete HLA DQ genetics that includes the |
| "pins and needles" sensation"). Many of my patients | | | | high-risk white blood cell patterns DQ2 and DQ8 for |
| also describe hypersensitivity of their skin such that | | | | Celiac disease AND get blood tests that include IgG |
| they do not like air blowing on them or their children | | | | and IgA gliadin antibodies. If your blood tests, |
| or spouses against their skin. Some admit to "bug | | | | including gliadin IgA and IgG antibodies, are negative |
| crawling" sensation on their skin, something called | | | | or normal then consider stool testing for gliadin |
| vermiculation in medical terms but rarely asked about | | | | antibodies in the stool ($99, |
| or given much thought by most doctors. Odd muscle | | | | The evidence continues to accumulate, though often |
| movements under the skin that some call a "bag of | | | | ignored or missed, that gluten is toxic to some |
| worms" medically known as fasiculations are also | | | | people's brains, even if they do not have CD. If you |
| very common but dismissed by many doctors. My | | | | do have Celiac disease it is likely you already have |
| wife, a physician with Celiac disease, actually had | | | | neurological problems and may be at risk despite |
| these occur while undergoing an EMG | | | | being on a gluten-free diet. Borrowing from the old |
| (electromyleograph, recording of muscle activity by | | | | advertisement against drug abuse "this is your brain |
| placing needle electrode into the muscle) exam by an | | | | on drugs" maybe we should be getting the word out |
| older neurologist. Despite observing these occurring | | | | "this is your brain on gluten". Despite your test |
| visually and the monitor showing "static like noise" the | | | | results, consider a trial of gluten-free diet after you |
| neurologist dismissed them as "normal". | | | | have your testing done if you have unexplained or |
| Many patients with Celiac disease also have what the | | | | unresponsive neurological problems. You owe to your |
| radiologists and neurologists call "UBO's" on MRI | | | | brain. Like my seven-year-old son said to one of our |
| exams of the brain. These unidentified bright objects | | | | friends, "maybe you should lay off the gluten". |