Abstract
Among 783 patients referred to our institute with different types of seizures as presenting symptom, systematic evaluation of antigliadin and antiendomysial antibodies in the serum has identified nine in whom jejunal biopsy has subsequently confirmed the diagnosis of celiac disease (CD). In three of them brain imaging showed the presence of calcified areas in the occipital region. They had complex partial seizures (CPS), associated in two with transient episodes of blindness. In another patient with CPS and generalized tonic-clonic seizures (GTCS) progressive multifocal cerebral calcifications were noted. In the other six patients with CPS and/or GTCS cerebral calcifications were absent. Symptoms of CD in all these cases were either not previously taken into account, or they were very mild or completely absent. In a group of 36 patients with clinically manifest CD, regular follow-up, and good compliance with the dietary regimen, no clinical seizures were reported. The pathogenetic mechanism and the relationship between epilepsy and an early diagnosis and treatment of celiac disease are discussed.
Similar content being viewed by others
References
Anbrosetto G, Antonini L, Tassinari CA (1992) Occipital lobe seizures related to clinically asyptomatic celiac disease in adulthood. Epilepsia 33: 476–481
Arroyo HA, Massaro M, De Rosa S, Caraballo R, Di Blasi M, Taratuto A, Fejerman N (1992) Epilepsy, posterior cerebral calcifications and celiac disease. 6th Congress of the International Child Neurology Association, Buenos Aires, 8–13 November, 1992, abstract 176
Cacciari E, Salardi S, Volta U (1985) Can antigliadin antibody detect symptomless coeliac disease in children with short stature? Lancet I:1469–1471
Caceres LP, Cervetto JL (1992) Case report — cerebral calcifications, epilepsy and coeliac disease. 6th Congress of the International Child Neurology Association, Buenos Aires, 8–13 November 1992, abstract 228
Chapman RWG, Laidlow JM, Colin-Jones D (1978) Increased evidence of epilepsy in coeliac disease. Br Med J 2: 250–251
Collin P, Pirttila T, Nurmikko T, Somer H, Erila T, Keyrilainen O (1991) Celiac disease, brain atrophy, and dementia. Neurology 41:372–375
Cooke WT, Smith WT (1966) Neurological disorders associated with adult coeliac disease. Brain 89:683–722
Del Guidice E, Pelosi L, Romano A, De Bellis P, Licenziati MR, Pastore I, Andria G (1984) Unexplained bilateral occipital calcification and reduced vision. Neuropediatrics 15:218–219
Della Cella G, Beluschi C, Cipollina F (1991) Intracranial calcifications-epilepsy-celiac disease: description of a case. Pediatr Med Chir 13:427–430
Del Rosario AM (1992) Oligosymptomatic coeliac disease and progressive cerebral calcifications with seizures. A case report. 6th Congress of the International Child Neurology Association. Buenos Aires, 8–13 November 1992, abstract 190
Fois A, Balestri P, Vascotto M, Farnetani MA, Di Bartolo RM, Di Marco V (1992) Epilepsy, progressive cerebral calcifications and coeliac disease. Lancet 340:1095
Fois A, Vascotto M, Di Bartolo RM, Di Marco V (1992) Epilepsy and celiac disease. Presentation of 19 cases. 6th Congress of the International Child Neurology Association, Buenos Aires, 8–13 November 1992, abstract 166
Gobbi G, Sorrenti G, Santucci M, Giovanardi Rossi P, Ambrosetto P, Michelucci R, Tassinari CA (1988) Epilepsy with bilateral occipital calcifications: a benign onset with progressive severity. Neurology 38:913–920
Gobbi G, Bouquet F, Greco L, Lambertini A, Tassinari CA, Ventura A, Zaniboni MG (1992) Coeliac disease, epilepsy, and cerebral calcifications. Lancet 340:439–443
Hed J, Lieden G, Ottoson E, Strom M (1986) IgA anti-gliadin antibodies and jejunal mucosal lesions in healthy blood donors. Lancet II:215
Katz A, Dyck RF, Bear RA (1979) Celiac disease associated with immune complex glomerulonephritis. Clin Nephrol 11:39–44
Kinney HC, Burger PC, Hurwitz BJ, Hijmans JC, Grant JP (1982) Degeneration of the central nervous system associated with celiac disease. J Neurol Sci 53:9–22
Kristoferitsch W, Pointner H (1987) Progressive cerebellar syndrome in adult coeliac disease. J Neurol 234: 116–118
Kumar V, Lerner A, Valeski JE, Beutner EH, Chorzelsi TP, Rossi T (1989) Endomysial antibodies in the diagnosis of celiac disease and the effect of gluten on antibody titers. Immunol Invest 18:533–544
Magaudda A, Della Bernardina B, Colamaria V, De Marco P, Sfaello ZM, Daniele O, Tortorella G, Meduri M (1992) The syndrome of bilateral occipital calcifications, epilepsy and celiac disease: report of 20 cases. 6th Congress of the International Child Neurology Association, Buenos Aires, 8–13 November 1992, abstract 105
Maki M, Kallonen K, Lahdeano NL, Visakorpi JK (1988) Changing pattern of childhood coeliac disease in Finland. Acta Paediatr Scand 77:408–412
Maki M, Holm K, Lipsanen V, Hallstrom O, Viander M, Collin P, Savilahti E, Koskimies S (1991) Serological markers and HLA genes among healty first-degree relatives of patients with coeliac disease. Lancet 338:1350–1353
Mazzetti di Pietralata M, Giorgetti GM, De Simone M, Leonardi C, Barletta PA, Ricciardi MM, Sandri G (1992) Subclinical coeliac disease. Ital J Gastroenterol 24:352–354
Meuwisse GW (1970) Round table discussion. Diagnostic criteria in coeliac disease. Acta Paediatr Scand 59:461–463
Meyers S, Dikman S, Spiera H, Schultz N, Janowitz HD (1981) Cutaneous vasculitis complicating coeliac disease. Gut 22:61–64
Molteni N, Bardella MT, Baldassarri AR, Bianchi PA (1988) Celiac disease associated with epilepsy and intracranial calcifications: report of two patients. Am J Gastroenterol 83:992–994
Morris JS, Ajdukiewcz AB, Read AE (1970) Neurological disorders in adult coeliac disease. Gut 11:549–554
Perticarari S, Presani G, Trevisan M, Savoini A, Cauci S (1987) Serum IgA and IgG antibodies to alpha-gliadin: comparison between two Elisa methods. Ricerca Clin Lab 17:323–329
Piattella L, Zamponi N, Cardinali C, Porfiri L, Tavoni MA (1993) Endocranial calcifications infantile celiac disease and epilepsy. Child's Nerv Syst 9: 172–175
Rush PJ, Inman R, Bernstein M, Carlen P, Resch L (1986) Isolated vasculitis of the central nervous system in a patient with celiac disease. Am J Med 81:1092–1094
Sammaritano M, Andermann F, Melanson D, Guberman A, Tinuper P, Gastaut H (1988) The syndrome of intractable epilepsy, bilateral occipital calcification and folic acid deficiency. Neurology 38 [Suppl 1]:239
Simila S, Kokkonen J, Kallionen M (1982) Cutaneous vasculitis as a manifestation of coeliac disease. Acta Pediatr Scand 71:1051–1054
Ventura A, Bouquet F, Sartorelli C, Barbi E, Torre G, Tommasini G (1991) Coeliac disease, folic acid deficiency and epilepsy with cerebral calcifications. Acta Paediatr Scand 80:559–562
Zaniboni MG, Lambertini A, Romeo N, Conti R, Ambrosioni G, Gobbi G, Ambrosetto P, Santucci M, Michelucci R, Tassinari CA (1989) Coeliac disease and epilepsy with occipital calcifications: an uncasual association. In: Bianchini G, Guandalini S, De Angelis GL, Walker-Smith JA (eds) First Joint Meeting of the British Society of Paediatric Gastroenterology and Nutrition and Italian Society of Paediatrics (abstracts book), Parma, 21–23 September 1989, p 54
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Fois, A., Vascotto, M., Di Bartolo, R.M. et al. Celiac disease and epilepsy in pediatric patients. Child's Nerv Syst 10, 450–454 (1994). https://doi.org/10.1007/BF00303610
Received:
Issue Date:
DOI: https://doi.org/10.1007/BF00303610