Neurological symptoms in patients with biopsy proven celiac disease
Identifieur interne : 002A50 ( Main/Merge ); précédent : 002A49; suivant : 002A51Neurological symptoms in patients with biopsy proven celiac disease
Auteurs : Katrin Bürk [Allemagne] ; Marie-Louise Farecki [Allemagne] ; Georg Lamprecht [Allemagne] ; Guenter Roth [Allemagne] ; Patrice Decker [Allemagne] ; Michael Weller [Suisse] ; Hans-Georg Rammensee [Allemagne] ; Wolfang Oertel [Allemagne]Source :
- Movement Disorders [ 0885-3185 ] ; 2009-12-15.
English descriptors
- KwdEn :
- MESH :
- complications : Celiac Disease.
- diagnosis : Celiac Disease.
- etiology : Nervous System Diseases.
- methods : Biopsy, Neurologic Examination.
- Adult, Aged, Female, Humans, Male, Middle Aged.
Abstract
In celiac disease (CD), the gut is the typical manifestation site but atypical neurological presentations are thought to occur in 6 to 10% with cerebellar ataxia being the most frequent symptom. Most studies in this field are focused on patients under primary neurological care. To exclude such an observation bias, patients with biopsy proven celiac disease were screened for neurological disease. A total of 72 patients with biopsy proven celiac disease (CD) (mean age 51 ± 15 years, mean disease duration 8 ± 11 years) were recruited through advertisements. All participants adhered to a gluten‐free diet. Patients were interviewed following a standard questionnaire and examined clinically for neurological symptoms. Medical history revealed neurological disorders such as migraine (28%), carpal tunnel syndrome (20%), vestibular dysfunction (8%), seizures (6%), and myelitis (3%). Interestingly, 35% of patients with CD reported of a history of psychiatric disease including depression, personality changes, or even psychosis. Physical examination yielded stance and gait problems in about one third of patients that could be attributed to afferent ataxia in 26%, vestibular dysfunction in 6%, and cerebellar ataxia in 6%. Other motor features such as basal ganglia symptoms, pyramidal tract signs, tics, and myoclonus were infrequent. 35% of patients with CD showed deep sensory loss and reduced ankle reflexes in 14%. Gait disturbances in CD do not only result from cerebellar ataxia but also from proprioceptive or vestibular impairment. Neurological problems may even develop despite strict adherence to a gluten‐free diet. © 2009 Movement Disorder Society
Url:
DOI: 10.1002/mds.22821
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<front><div type="abstract" xml:lang="en">In celiac disease (CD), the gut is the typical manifestation site but atypical neurological presentations are thought to occur in 6 to 10% with cerebellar ataxia being the most frequent symptom. Most studies in this field are focused on patients under primary neurological care. To exclude such an observation bias, patients with biopsy proven celiac disease were screened for neurological disease. A total of 72 patients with biopsy proven celiac disease (CD) (mean age 51 ± 15 years, mean disease duration 8 ± 11 years) were recruited through advertisements. All participants adhered to a gluten‐free diet. Patients were interviewed following a standard questionnaire and examined clinically for neurological symptoms. Medical history revealed neurological disorders such as migraine (28%), carpal tunnel syndrome (20%), vestibular dysfunction (8%), seizures (6%), and myelitis (3%). Interestingly, 35% of patients with CD reported of a history of psychiatric disease including depression, personality changes, or even psychosis. Physical examination yielded stance and gait problems in about one third of patients that could be attributed to afferent ataxia in 26%, vestibular dysfunction in 6%, and cerebellar ataxia in 6%. Other motor features such as basal ganglia symptoms, pyramidal tract signs, tics, and myoclonus were infrequent. 35% of patients with CD showed deep sensory loss and reduced ankle reflexes in 14%. Gait disturbances in CD do not only result from cerebellar ataxia but also from proprioceptive or vestibular impairment. Neurological problems may even develop despite strict adherence to a gluten‐free diet. © 2009 Movement Disorder Society</div>
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<front><div type="abstract" xml:lang="en">In celiac disease (CD), the gut is the typical manifestation site but atypical neurological presentations are thought to occur in 6 to 10% with cerebellar ataxia being the most frequent symptom. Most studies in this field are focused on patients under primary neurological care. To exclude such an observation bias, patients with biopsy proven celiac disease were screened for neurological disease. A total of 72 patients with biopsy proven celiac disease (CD) (mean age 51 ± 15 years, mean disease duration 8 ± 11 years) were recruited through advertisements. All participants adhered to a gluten‐free diet. Patients were interviewed following a standard questionnaire and examined clinically for neurological symptoms. Medical history revealed neurological disorders such as migraine (28%), carpal tunnel syndrome (20%), vestibular dysfunction (8%), seizures (6%), and myelitis (3%). Interestingly, 35% of patients with CD reported of a history of psychiatric disease including depression, personality changes, or even psychosis. Physical examination yielded stance and gait problems in about one third of patients that could be attributed to afferent ataxia in 26%, vestibular dysfunction in 6%, and cerebellar ataxia in 6%. Other motor features such as basal ganglia symptoms, pyramidal tract signs, tics, and myoclonus were infrequent. 35% of patients with CD showed deep sensory loss and reduced ankle reflexes in 14%. Gait disturbances in CD do not only result from cerebellar ataxia but also from proprioceptive or vestibular impairment. Neurological problems may even develop despite strict adherence to a gluten‐free diet. © 2009 Movement Disorder Society</div>
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<wicri:regionArea>Department of Neurology, University of Marburg, Marburg</wicri:regionArea>
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<region type="district" nuts="2">District de Giessen</region>
<settlement type="city">Marbourg</settlement>
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</author>
<author><name sortKey="Farecki, Marie Louise" sort="Farecki, Marie Louise" uniqKey="Farecki M" first="Marie-Louise" last="Farecki">Marie-Louise Farecki</name>
</author>
<author><name sortKey="Lamprecht, Georg" sort="Lamprecht, Georg" uniqKey="Lamprecht G" first="Georg" last="Lamprecht">Georg Lamprecht</name>
</author>
<author><name sortKey="Roth, Guenter" sort="Roth, Guenter" uniqKey="Roth G" first="Guenter" last="Roth">Guenter Roth</name>
</author>
<author><name sortKey="Decker, Patrice" sort="Decker, Patrice" uniqKey="Decker P" first="Patrice" last="Decker">Patrice Decker</name>
</author>
<author><name sortKey="Weller, Michael" sort="Weller, Michael" uniqKey="Weller M" first="Michael" last="Weller">Michael Weller</name>
</author>
<author><name sortKey="Rammensee, Hans Georg" sort="Rammensee, Hans Georg" uniqKey="Rammensee H" first="Hans-Georg" last="Rammensee">Hans-Georg Rammensee</name>
</author>
<author><name sortKey="Oertel, Wolfang" sort="Oertel, Wolfang" uniqKey="Oertel W" first="Wolfang" last="Oertel">Wolfang Oertel</name>
</author>
</titleStmt>
<publicationStmt><idno type="wicri:source">PubMed</idno>
<date when="2009">2009</date>
<idno type="doi">10.1002/mds.22821</idno>
<idno type="RBID">pubmed:19845007</idno>
<idno type="pmid">19845007</idno>
<idno type="wicri:Area/PubMed/Corpus">001B35</idno>
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<sourceDesc><biblStruct><analytic><title xml:lang="en">Neurological symptoms in patients with biopsy proven celiac disease.</title>
<author><name sortKey="Burk, Katrin" sort="Burk, Katrin" uniqKey="Burk K" first="Katrin" last="Bürk">Katrin Bürk</name>
<affiliation wicri:level="3"><nlm:affiliation>Department of Neurology, University of Marburg, Marburg, Germany. buerk@ngi.de</nlm:affiliation>
<country xml:lang="fr">Allemagne</country>
<wicri:regionArea>Department of Neurology, University of Marburg, Marburg</wicri:regionArea>
<placeName><region type="land" nuts="1">Hesse (Land)</region>
<region type="district" nuts="2">District de Giessen</region>
<settlement type="city">Marbourg</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Farecki, Marie Louise" sort="Farecki, Marie Louise" uniqKey="Farecki M" first="Marie-Louise" last="Farecki">Marie-Louise Farecki</name>
</author>
<author><name sortKey="Lamprecht, Georg" sort="Lamprecht, Georg" uniqKey="Lamprecht G" first="Georg" last="Lamprecht">Georg Lamprecht</name>
</author>
<author><name sortKey="Roth, Guenter" sort="Roth, Guenter" uniqKey="Roth G" first="Guenter" last="Roth">Guenter Roth</name>
</author>
<author><name sortKey="Decker, Patrice" sort="Decker, Patrice" uniqKey="Decker P" first="Patrice" last="Decker">Patrice Decker</name>
</author>
<author><name sortKey="Weller, Michael" sort="Weller, Michael" uniqKey="Weller M" first="Michael" last="Weller">Michael Weller</name>
</author>
<author><name sortKey="Rammensee, Hans Georg" sort="Rammensee, Hans Georg" uniqKey="Rammensee H" first="Hans-Georg" last="Rammensee">Hans-Georg Rammensee</name>
</author>
<author><name sortKey="Oertel, Wolfang" sort="Oertel, Wolfang" uniqKey="Oertel W" first="Wolfang" last="Oertel">Wolfang Oertel</name>
</author>
</analytic>
<series><title level="j">Movement disorders : official journal of the Movement Disorder Society</title>
<idno type="eISSN">1531-8257</idno>
<imprint><date when="2009" type="published">2009</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term>
<term>Aged</term>
<term>Biopsy (methods)</term>
<term>Celiac Disease (complications)</term>
<term>Celiac Disease (diagnosis)</term>
<term>Female</term>
<term>Humans</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Nervous System Diseases (etiology)</term>
<term>Neurologic Examination (methods)</term>
</keywords>
<keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Celiac Disease</term>
</keywords>
<keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Celiac Disease</term>
</keywords>
<keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Nervous System Diseases</term>
</keywords>
<keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Biopsy</term>
<term>Neurologic Examination</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Adult</term>
<term>Aged</term>
<term>Female</term>
<term>Humans</term>
<term>Male</term>
<term>Middle Aged</term>
</keywords>
</textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en">In celiac disease (CD), the gut is the typical manifestation site but atypical neurological presentations are thought to occur in 6 to 10% with cerebellar ataxia being the most frequent symptom. Most studies in this field are focused on patients under primary neurological care. To exclude such an observation bias, patients with biopsy proven celiac disease were screened for neurological disease. A total of 72 patients with biopsy proven celiac disease (CD) (mean age 51 +/- 15 years, mean disease duration 8 +/- 11 years) were recruited through advertisements. All participants adhered to a gluten-free diet. Patients were interviewed following a standard questionnaire and examined clinically for neurological symptoms. Medical history revealed neurological disorders such as migraine (28%), carpal tunnel syndrome (20%), vestibular dysfunction (8%), seizures (6%), and myelitis (3%). Interestingly, 35% of patients with CD reported of a history of psychiatric disease including depression, personality changes, or even psychosis. Physical examination yielded stance and gait problems in about one third of patients that could be attributed to afferent ataxia in 26%, vestibular dysfunction in 6%, and cerebellar ataxia in 6%. Other motor features such as basal ganglia symptoms, pyramidal tract signs, tics, and myoclonus were infrequent. 35% of patients with CD showed deep sensory loss and reduced ankle reflexes in 14%. Gait disturbances in CD do not only result from cerebellar ataxia but also from proprioceptive or vestibular impairment. Neurological problems may even develop despite strict adherence to a gluten-free diet.</div>
</front>
</TEI>
</PubMed>
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