NEUROLOGICAL MANIFESTATIONS OF CELIAC DISEASE

ABSTRACT- Celiac disease (CD / Nontropicalsprue, gluten-sensitive enteropathy) is a malabsortive condi-tion in which an allergic reaction to the cereal grain-protein gluten (present in wheat, rye and barley) caus-es small intestine mucosal injury. The onset is in the first four decades of life, with a female to male ratio of 2:1. It may be associated with a wide spectrum of neurological manifestations including cerebellar atax-ia, epileptic seizures, dementia, neuropathy, myopathy and multifocal leucoencephalopathy. We report three patients with neurological manifestations related with CD: one with cerebellar ataxia, one with epilepsy and one with cognitive impairment. The diagnosis of CD was confirmed by serologic tests (antiendomysial and antigliadin antibodies) and biopsy of the small intestine. In two patients the neurological symptoms preceded the gastrointestinal abnormalities and in all of them gluten restriction failed to improve the neu-rological disability. Conclusion: CD should be ruled out in the differential diagnosis of neurological dys-function of unknown cause, including ataxia, epilepsy and dementia. A gluten free diet, the mainstay of treatment, failed to improve the neurological disability. KEY WORDS: celiac disease, cerebellar ataxia, epilepsy, cognitive impairment. Manifestações neurológicas da doença celíaca RESUMO- A doença celíaca (DC, enteropatia sensível ao glúten) é desordem caracterizada por mal absorçã