| Brain dysfunction may be the only or the main sign | | | | daughter's celiac disease. Though she does not meet |
| of gluten related disease. Dr. Mario Hadjivassiliou | | | | strict criteria for celiac disease she has the major |
| recently reported at the International Celiac | | | | gene for celiac and has elevated gliadin antibodies in |
| Symposium that his neurology clinic has followed over | | | | her stool and blood. Increased intraepithelial |
| 300 patients with gluten sensitivity presenting with | | | | lymphocytes were seen on duodenal biopsy but not |
| various symptoms. In his clinic the most common | | | | sufficient to confirm celiac disease. Yet she is |
| gluten related neurological disorder is ataxia, a | | | | improved on a gluten free diet. Dr. Hadjivassiliou has |
| condition of impaired balance, present in almost half. | | | | confirmed to me personally by e-mail that these |
| However peripheral neuropathy, myopathy, | | | | neuropathies will get worse with continued gluten |
| headaches, and seizures are also neurological | | | | ingestion but most improve with gluten free diet |
| manifestations of gluten related brain disorders. | | | | though it may take several years to do so. Long |
| Gluten ataxia, the most common cause of previously | | | | standing symptoms may never completely reverse. |
| unexplained ataxia, is associated with gut disease in | | | | This makes it very important not to delay considering |
| only about a third. Usually there is an absence of the | | | | gluten as a cause of neurological symptoms nor delay |
| specific antibodies in the blood diagnostic for celiac | | | | diagnostic testing or institution of a gluten free diet. |
| disease but elevated gliadin antibodies. Brain tissue | | | | In my opinion a gluten free diet trial should be |
| examined after brain biopsies or an autopsy has been | | | | offered or considered for all neurological and |
| found to contain deposits of gliadin and/or tissue | | | | psychiatric symptoms. However, I encourage anyone |
| transglutaminase in the absence of antibodies in the | | | | considering such a diet to first undergo adequate |
| blood. | | | | testing for celiac disease first because once a gluten |
| About 60% of patients with gluten ataxia have | | | | free diet is initiated the tests may be falsely negative |
| shrinkage of the cerebellum portion of their brain. | | | | within 2-3 weeks of the diet. Even if the tests are |
| They also may have irreversible loss of brain Purkinje | | | | negative for celiac disease before restricting gluten |
| cells. MRI scans of the brain often reveal bright white | | | | then a trial of gluten free diet is suggested. Regarding |
| spots in this area rather than the area where this | | | | gluten and the brain Dr. Hadjivassiliou was quoted as |
| occurs in multiple sclerosis, a condition that may be | | | | saying "there is a historical misconception that gluten |
| mimicked by gluten injury. | | | | sensitivity is solely a disease of the gut...to recognize |
| Gluten causes 34% of all unexplained sporadic axonal | | | | the neurological impact, you have to appreciate it is a |
| neuropathies. Gluten sensitive enteropathy is 10 times | | | | systemic disorder." This is my personal and |
| more common in these people. I recently treated a | | | | professional experience as a gastroenterologist who |
| woman who had years of a known diagnosis of such | | | | is Food Allergies Specialist - the Food Doc and celiac |
| a neuropathy though she had never been tested for | | | | disease expert who is regularly corresponding with |
| celiac disease. She came to me after I diagnosed her | | | | people from all over the world as the Food Doc. |