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How frequent is celiac disease among epileptic patients?

BACKGROUND
A variety of neurological disorders have been reported in association with celiac disease (CD) including epilepsy, ataxia, neuropathy and multifocal leucoencephalopathy. The purpose of this study was to assess the prevalence of CD among epileptic patients.


METHODS
Our study population consisted of 108 consecutive unexplained epileptic patients from Epilepsy Clinics. Patients who were able to give informed consent were invited to undergo screening for CD in a gastroenterology clinic. The diagnosis of CD was determined by IgA anti-tissue transglutaminase (t-TG) antibodies and by small intestine biopsy. Histopathologic changes were interpreted according to the Marsh classification.


RESULTS
A total of 108 consecutive epileptic patients (72 females, 36 males) ranging from 2-64 years (mean: 23.44, SD: 12.1) were studied. Positive IgA anti t-TG were detected in 4 of 108 epileptic patients (3.7%), while the known prevalence of CD in the study area was 0.6%.The intestinal biopsy confirmed the diagnosis of CD in three patients and was interpreted as Marsh I. In the other patient, small intestinal biopsy indicated only slightly increased number of intraepithelial lymphocytes. There was a significant difference between patients with CD and without CD for two symptoms: diarrhea and aphtous lesions (p<0.05).


CONCLUSION
Prevalence of CD was increased among patients with epilepsy of unknown etiology. It is important to investigate CD in any patient with idiopathic epilepsy even in the absence of digestive symptoms.