The electroclinical ictal findings of 4 epileptic patients with clinically asymptomatic celiac disease are reported from the University of Bologna, Italy. All patients had paroxysmal visual manifestations and EEG seizure discharges arising from the occipital lobe. CT in 2 patients showed occipital calcifications. A gluten-free diet was not beneficial and polytherapy with antiepileptic drugs aggravated the seizures in 3 cases. Epilepsy and evidence of steatorrhea and growth failure were present in early childhood. The diagnosis of celiac disease was made by tests for serum folate level, a d-zylose absorption test, anti-gliadin antibody test and jejunal biopsy which showed villous atrophy. [1]

COMMENT. The same authors had investigated 10 patients with epilepsy and occipital cerebral calcification and had found evidence of celiac disease in 6. All patients with epilepsy and posterior cerebral calcification should be investigated for possible celiac disease. [2]