There is reasonable evidence of neurological problems in celiac disease (CD), even those well treated with a gluten-free diet should undergo periodic neurological examinations. Peripheral neuropathy is found in almost half of people with CD. Previously, neurological complications in celiac disease were reported to be 36% or more than a third. Some unexplained neurological problems are present but are not recognized by the patient or their doctor in many patients and some have various problems. Unfortunately, since brain imaging is not routinely performed or recommended in newly diagnosed people, we don’t really know how high these numbers really can be. More astonishing is the fact that we are still learning about people who do not meet the diagnostic criteria for celiac disease, but have gluten-related neurological problems that respond to a gluten-free diet.

There are many neurological problems found in undiagnosed and untreated celiac disease, but they include neuropathy, balance problems (ataxia), seizures, MS-like symptoms, headaches, memory impairment, depression and anxiety, lack attention deficit (ADD / ADHD), schizophrenia, dementia, muscle weakness, delayed child development, autism (Asperger). The sad truth is that many patients have delays in diagnosis that result in a delay in treatment and a poor response even when they adopt a strict gluten-free diet. The mean delay in diagnosis in adults is between eleven and thirteen years. Dr. Hadjivassiliou, a neurologist in England who is considered the world’s expert on gluten-related neurological problems, has communicated to me by email and in writing that responses to a gluten-free diet may take five years and if the neurological condition has been complete for a long time. recovery is not likely.

Symptoms of neuropathy are paresthesia (numbness) or dysesthesia (burning, tingling, heaviness, “tingly feeling”). Many of my patients also describe hypersensitivity of the skin in such a way that they do not like the air to blow on them or their children. or spouses against their skin. Some admit a sensation of “insect tingling” on the skin, something called vermiculation in medical terms, but most doctors rarely ask or think much about it. Strange muscle movements under the skin that some call “bag of worms” medically known as fasiculations are also very common, but many doctors dismiss them. My wife, a doctor with celiac disease, actually had these reactions while undergoing a EMG examination (electromileography, recording of muscle activity by placing a needle electrode in the muscle) Senior neurologist Despite observing that these occurred visually and that the monitor showed “noise as static”, the neurologist dismissed them as ” normal “.

Many celiac disease patients also have what radiologists and neurologists call “UBO” on MRI scans of the brain. These unidentified glowing objects (think a UFO) are white dots that show up on brain images. When found in certain locations in the brain, they are highly suggestive of multiple sclerosis (multiple healing points in the brain). However, although many people with CD have symptoms similar to those of MS and these symptoms often respond to a gluten-free diet when started early enough, the UBOs seen on MRI of the brain are generally not found in the classic areas of MS. Instead, they are commonly found in areas of the brain associated with migraines or poor balance (ataxia).

Some are seen in children associated with rare seizure problems even without obvious bowel symptoms. A classic specific syndrome associated with epilepsy is well recognized in both children and adults who have calcifications in the brain that can be detected by computed tomography or magnetic resonance imaging. Epilepsy is well documented, but the studies are confusing enough that there is not a good consensus regarding the risk and recommended screening of all children with epilepsy.

Personally and professionally, I have observed all the neurological complications of celiac disease and most of them I have also noticed in patients in whom I have not been able to confirm CD but who have what I believe are objective signs and / or genetic risk for it. gluten. sensitivity. I have patients with MS-like symptoms, unexplained chronic neuropathy, headaches, attention difficulties, autistic behaviors, and developmental delays who have responded to a gluten-free diet, but if they would have listened to the doctors who maintained a diet so “restrictive, expensive and difficult to follow” The diet should only be “imposed” on those with an established diagnosis of celiac disease.

If you have neurological problems, get screened for celiac disease before starting a gluten-free diet. If your test result is negative for CD, make sure you are tested for complete HLA DQ genetics including DQ2 and DQ8 high risk white blood cell patterns for celiac disease AND get blood tests that include IgG antibodies and IgA gliadin. If your blood tests, including gliadin IgA and IgG antibodies, are negative or normal, consider having a stool test for gliadin antibodies in the stool ($ 99, http://www.enterolab.com).

The evidence continues to accumulate, although it is often ignored or overlooked, that gluten is toxic to the brains of some people, even if they do not have CD. If you have celiac disease, you likely already have neurological problems and may be at risk despite following a gluten-free diet. Borrowing from the old anti-drug ad “this is your brain on drugs”, maybe we should spread the word “this is your brain on gluten”. Despite your test results, consider a gluten-free diet test after the test has been done if you have unexplained or unresponsive neurological problems. You owe it to your brain. As my seven year old son told one of our friends, “maybe you should give up gluten.”