Brain dysfunction may be the only or the main sign of a gluten-related disease. Dr. Mario Hadjivassiliou recently reported at the International Symposium on Celiac Disease that his neurology clinic has followed more than 300 gluten-sensitive patients with various symptoms. In her clinic, the most common neurological disorder related to gluten is ataxia, a balance disorder, present in almost half. However, peripheral neuropathy, myopathy, headaches, and seizures are also neurological manifestations of gluten-related brain disorders.
Gluten ataxia, the most common cause of ataxia so far unexplained, is associated with bowel disease in only about a third. Usually there are no specific antibodies in the blood diagnosis of celiac disease but high anti-gliadin antibodies. Brain tissue examined after brain biopsies or an autopsy was found to contain deposits of gliadin and / or tissue transglutaminase in the absence of antibodies in the blood.
About 60% of patients with gluten ataxia have a narrowing of the cerebellum part of their brain. They may also have irreversible loss of brain Purkinje cells. MRI scans of the brain often reveal shiny white spots in this area rather than the area where it occurs in multiple sclerosis, a condition that can be mimicked by a gluten injury.
Gluten is responsible for 34% of all unexplained sporadic axonal neuropathies. Gluten sensitive enteropathy is 10 times more common in these people. I recently treated a woman who had years of a known diagnosis of such neuropathy although she had never been tested for celiac disease. She came to see me after diagnosing her daughter with celiac disease. Although she does not meet the strict criteria for celiac disease, she has the main gene for celiac disease and has high anti-gliadin antibodies in her stool and blood. An increase in intraepithelial lymphocytes was observed on the duodenal biopsy but not sufficient to confirm celiac disease. Still, it is improved with a gluten-free diet. Dr Hadjivassiliou confirmed to me personally via email that these neuropathies will worsen with continued gluten ingestion, but most improve with a gluten-free diet, although it may take several years to do so. Long-standing symptoms may never fully reverse.
It is therefore very important not to delay the consideration of gluten as a cause of neurological symptoms nor to delay diagnostic tests or the initiation of a gluten-free diet. In my opinion, a gluten-free diet trial should be offered or considered for all neurological and psychiatric symptoms. However, I encourage anyone considering such a diet to first undergo adequate testing for celiac disease, as once a gluten-free diet is initiated the tests can be false negative within 2-3 weeks. the system of government. Even if the tests are negative for celiac disease before restricting gluten, a gluten-free diet trial is suggested. Regarding gluten and the brain, Dr Hadjivassiliou is said to have said that “there is a historical misconception that gluten sensitivity is only a bowel disease … to recognize the neurological impact, one has to understand that” it is a systemic disorder ”. It is my personal and professional experience as a gastroenterologist that is Food Allergy Specialist – The Food Doc and a celiac expert who regularly corresponds with people around the world under the name of Food Doc.