Neurological manifestations of celiac disease

Abstract

Objectives. To review the current knowledge of the neurologic manifestations associated with celiac disease.
Methods. Examination of the literature related to the topic studied.
Results. Since its first description in the last century, the gastrointestinal manifestations of celiac disease have been of paramount importance. However, in the last years a frequent association of other manifestations, particularly neurologic and psychiatric, have been reported. In the last decade, different neurologic manifestations, not explained by casual association, have been observed in the celiac disease patients. Among them, we have the epilepsy and occipital calcifications syndrome, spinocerebellar degeneration, brain tumors, myelopathy, peripheral neuropathy, headache and migraine, basilar skull impression, as well as psychiatric disorders such as depression and schizophrenia. Currently, the pathogenesis of these manifestations is not completely clear although genetic and immune factors and a possible absorption of toxins and deficiency states related to the malabsorption syndrome characteristic of this disease could play a role.
Conclusions. In patients with the neurologic manifestations described above, the existence of celiac disease should be ruled out, even when other gastrointestinal manifestations are lacking, because a gluten-free diet and a vitamin therapy can achieve the improvement of some symptoms.