Thursday, June 28, 2012

Brain And Neurological Problems work on roughly Half Of Celiacs Even With A Gluten Free Diet

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There is uncostly evidence of neurological problems in Celiac disease (Cd) even those well treated on a gluten-free diet should endure periodic neurological screening. Peripheral neuropathy is found in almost half of population with Cd. Previously, neurological complications in Celiac disease were reported to be as high as 36% or more than a third. Some unexplained neurological problems are present but not recognized by the sick person or their physician in many patients and some have any problems. Unfortunately, since brain imaging is not routinely done or recommended in those who are newly diagnosed we don't verily know how high these numbers may be verily be. More startling is the fact that we are still studying about population who fail to meet diagnostic criteria for Celiac disease but are being found to have gluten related neurological problems that sass to a gluten-free diet.

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There are many neurological problems that in undiagnosed and untreated Celiac disease but include neuropathy, balance problems (ataxia), seizures, Ms-like symptoms, headaches, memory impairment, depression and anxiety, inattention (Add/Adhd), schizophrenia, dementia, muscle weakness, childhood developmental delay, autism (Asperger's). The sad truth is that many patients have delays in pathology that supervene in delayed rehabilitation and poor response even while adopting a accurate gluten free diet. The midpoint delay of pathology in adults is in the middle of eleven and thirteen years. Dr. Hadjivassiliou, a neurologist in England who is thought about the world's master in gluten related neurological problems has communicated to me by e-mail and written that responses to a gluten-free diet may take five years and if the neurological health has been longstanding perfect recovery is not likely.

The symptoms of neuropathy are paresthesia (numbness) or dysthesia (burning, tingling, heaviness, "pins and needles" sensation"). Many of my patients also recite hypersensitivity of their skin such that they do not like air blowing on them or their children or spouses against their skin. Some admit to "bug crawling" sensation on their skin, something called vermiculation in curative terms but rarely asked about or given much thought by most doctors. Odd muscle movements under the skin that some call a "bag of worms" medically known as fasiculations are also very coarse but dismissed by many doctors. My wife, a physician with Celiac disease, verily had these occur while undergoing an Emg (electromyleograph, recording of muscle activity by placing needle electrode into the muscle) exam by an older neurologist. Despite observing these occurring visually and the monitor showing "static like noise" the neurologist dismissed them as "normal".

Many patients with Celiac disease also have what the radiologists and neurologists call "Ubo's" on Mri exams of the brain. These unidentified spicy objects (think Ufo) are white spots that show up on images of the brain. When found in positive locations of the brain they are very suggestive of complicated sclerosis (multiple scarring spots in the brain). However, though many population with Cd have Ms like symptoms and these symptoms often sass to a gluten free diet when started early enough, the Ubo's seen on Mri of the brain are typically not in the first-rate areas of Ms. Instead it is coarse to find them in areas of the brain related with migraines or balance strangeness (ataxia).

Some are seen in children related with strange seizure problems even without positive intestinal symptoms. A first-rate definite syndrome is very well recognized related with epilepsy in both children and adults who have calcifications in their brain that can be detected by Ct scan or Mri. Epilepsy is well documented but the studies are confusing adequate that there is not a good consensus with regard to the risk and recommended screening of all children with epilepsy.

Personally and professionally I have observed all of the neurological complications of Celiac disease and most of them I have also noted 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 gluten sensitivity. I have patients with Ms-like symptoms, chronic unexplained neuropathy, headaches, attention difficulties, autistic behaviors and developmental delays who have responded to gluten-free diet but if they had listened to doctors who maintained such a "restrictive, expensive, hard to follow" diet should only be "imposed" on those with a established pathology of Celiac disease.

If you have neurological problems get testing for Celiac disease before beginning a gluten-free diet. If you test negative for Cd, make sure they test you for the perfect Hla Dq genetics that includes the high-risk white blood cell patterns Dq2 and Dq8 for Celiac disease And get blood tests that include IgG and IgA gliadin antibodies. If your blood tests, including gliadin IgA and IgG antibodies, are negative or general then consider stool testing for gliadin antibodies in the stool (, http://www.enterolab.com).

The evidence continues to accumulate, though often ignored or missed, that gluten is toxic to some people's brains, even if they do not have Cd. If you do have Celiac disease it is likely you already have neurological problems and may be at risk despite being on a gluten-free diet. Borrowing from the old advertisement against drug abuse "this is your brain on drugs" maybe we should be getting the word out "this is your brain on gluten". Despite your test results, consider a trial of gluten-free diet after you have your testing done if you have unexplained or unresponsive neurological problems. You owe to your brain. Like my seven-year-old son said to one of our friends, "maybe you should lay off the gluten".

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