Coeliac disease is an autoimmune disorder characterised by an immune reaction to gluten, a protein found in wheat, barley, and rye. While the condition primarily affects the small intestine, it can also have systemic effects and manifest in various parts of the body, including the neurological system. Neurological manifestations associated with coeliac disease are increasingly recognised and can present as a range of symptoms and conditions.
Gluten Ataxia: One of the most well-known neurological manifestations of coeliac disease is gluten ataxia. It is a rare condition characterised by the loss of balance and co-ordination due to damage to the cerebellum, a part of the brain responsible for movement and co-ordination. Gluten ataxia typically occurs in individuals with coeliac disease who are sensitive to gluten and can develop even in the absence of gastro-intestinal symptoms.
Peripheral Neuropathy: Peripheral neuropathy refers to damage or dysfunction of the peripheral nerves, leading to symptoms such as numbness, tingling, and weakness in the extremities. Research suggests that coeliac disease may contribute to the development of peripheral neuropathy, although the exact mechanisms are not fully understood. The condition can improve with a strict gluten-free diet.
Epilepsy and Seizures: Some individuals with coeliac disease may experience seizures or epilepsy. The relationship between coeliac disease and epilepsy is not yet fully elucidated, but studies have found an increased prevalence of coeliac disease among people with epilepsy compared to the general population. It is believed that the inflammation and immune response triggered by gluten in susceptible individuals may contribute to the development of seizures.
Headaches and Migraines: Headaches, including migraines, are common neurological symptoms reported by individuals with coeliac disease. The exact mechanisms linking coeliac disease and headaches are not fully understood. However, studies have shown that adherence to a gluten-free diet can lead to a reduction in the frequency and severity of migraines in affected individuals.
Cognitive Impairment and Behavioural Changes: Coeliac disease has also been associated with cognitive impairment, including difficulties with memory, attention, and concentration. Some individuals may experience "brain fog" or mental fatigue. Behavioural changes, such as irritability, depression, and anxiety, have also been reported. These symptoms can significantly impact an individual's quality of life and may improve with a gluten-free diet.
It is important to note that neurological manifestations in coeliac disease can occur in the absence of gastrointestinal symptoms, making diagnosis challenging. If someone experiences unexplained neurological symptoms, it is essential to consider coeliac disease as a potential underlying cause. A proper diagnosis involves blood tests to detect specific antibodies associated with coeliac disease and confirmation through small intestinal biopsy. The primary treatment for neurological manifestations of coeliac disease is adherence to a strict gluten-free diet. Removing gluten from the diet can help prevent further damage to the intestines and alleviate associated neurological symptoms. In some cases, additional treatments such as medications to manage specific symptoms or conditions may be necessary.
Coeliac disease can have neurological manifestations that range from gluten ataxia and peripheral neuropathy to epilepsy, headaches, cognitive impairment, and behavioural changes. Recognising these potential neurological symptoms and their association with coeliac disease is crucial for timely diagnosis and appropriate management, which primarily involves following a gluten-free diet. If you suspect you may have coeliac disease or experience unexplained neurological symptoms, it is essential to consult with a healthcare professional for proper evaluation and guidance.