The frequency of IgG and IgA antigliadin antibodies, a measure of cryptic gluten sensitivity, and celiac disease was studied using ELISA in 147 adult patients admitted to the Royal Hallamshire Hospital, Sheffield, UK, for neurologic investigation. Of 53 patients with neurological dysfunction of unknown cause, including 25 with ataxia and 20 with peripheral neuropathy, 30 (57%) had positive antigliadin antibody titers, compared to only 5% of 94 patients with specific diagnoses, such as stroke, MS, and Parkinsonism, and 12% of 50 healthy blood donors. In antigliadin-positive patients with ataxia or neuropathy of unknown cause, duodenal biopsies revealed histological evidence of celiac disease in 35% and non-specific duodenitis in 38%. Only one had low vitamin B12 levels and the biopsy was normal. Gluten sensitivity was a common finding in this group of adult patients with ataxia and peripheral neuropathy of unknown cause. [1]

COMMENT. This investigation underscores the importance of nutrition and diet in some neurological disorders of undetermined etiology. Antigliadin antibody estimation should be considered in the investigation of patients with neurological dysfunction of unknown cause, including those with refractory seizures, and especially if associated with occipital calcifications. Patients with histological evidence of celiac disease are treated with a gluten-free diet. However, those celiac patients with seizure complications and occipital calcifications are not always benefited by diet, and surgical resection of the involved occipital cortex may be required. (see Progress in Pediatric Neurology II, PNB Publishers, 1994, pp71-73).