Idiopathic cerebellar ataxia associated with celiac disease: lack of distinctive neurological features

J Neurol Neurosurg Psychiatry. 1999 Jan;66(1):32-5. doi: 10.1136/jnnp.66.1.32.

Abstract

Objectives: To determine the occurrence of celiac disease in a population of ataxic patients without definite diagnosis and to characterise distinctive features which may help to differentiate cerebellar ataxia with and without celiac disease.

Methods: Twenty four ataxic patients without definite diagnosis (group A) and 23 ataxic patients with definite diagnosis (group B) were screened for antigliadin (AGAs) and antiendomysium antibodies (EMAs). Patients with a positive AGA or EMA test underwent endoscopic biopsy of the duodenal mucosa.

Results: There was an increased prevalence of celiac disease in group A (3/24) compared with group B (0/23). None of the celiac patients presented gastrointestinal symptoms or malabsorption signs. None of the ataxic patients with celiac disease had early onset ataxia.

Conclusions: Celiac disease is associated with ataxic syndromes without definite diagnosis, suggesting that it plays a part in the pathogenesis of some ataxic syndromes. The absence of distinctive neurological features in ataxic patients with celiac disease suggests that a search should be made for celiac disease markers in all ataxic patients without definite diagnosis.

MeSH terms

  • Adult
  • Aged
  • Antibodies / immunology
  • Biopsy
  • Celiac Disease / complications*
  • Celiac Disease / diagnosis
  • Celiac Disease / immunology
  • Cerebellar Ataxia / diagnosis*
  • Cerebellar Ataxia / etiology*
  • Duodenum / pathology
  • Female
  • Gliadin / blood
  • Gliadin / immunology
  • Humans
  • Immunoglobulin A / blood
  • Immunoglobulin A / immunology
  • Immunoglobulin G / blood
  • Immunoglobulin G / immunology
  • Male
  • Median Nerve / physiology
  • Middle Aged
  • Muscle, Skeletal / innervation
  • Neural Conduction / physiology
  • Tibial Nerve / physiology

Substances

  • Antibodies
  • Immunoglobulin A
  • Immunoglobulin G
  • Gliadin