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Central pontine myelinolysis presenting with tremor in a child with celiac disease

Preeti Sharma1, Suvasini Sharma, Neha Panwar

  • 11Department of Pediatrics, Lady Hardinge Medical College and associated Kalawati Saran Children's Hospital, New Delhi, India.

Journal of Child Neurology
|February 8, 2013
PubMed

Insights

A child

Area of Science:

  • Pediatric Neurology
  • Gastroenterology
  • Neuroimmunology

Background:

  • Celiac disease is an autoimmune disorder triggered by gluten ingestion.
  • Neurological manifestations of celiac disease are diverse but uncommon.
  • Central pontine myelinolysis (CPM) is a rare demyelinating condition.

Observation:

  • A 4-year-old boy presented with a 7-day history of tremor, 1 year of diarrhea, and poor weight gain.
  • Brain MRI revealed findings suggestive of central pontine myelinolysis.
  • Elevated serum tissue transglutaminase and duodenal biopsy confirmed celiac disease.

Findings:

  • The patient's tremor resolved within 3 months of initiating a gluten-free diet.
  • Follow-up brain imaging demonstrated complete resolution of the central pontine myelinolysis lesion.
  • This case illustrates an unusual neurological presentation of celiac disease.

Implications:

  • Highlights the potential for central pontine myelinolysis as a presenting neurological symptom in pediatric celiac disease.
  • Emphasizes the importance of considering celiac disease in malnourished children with neurological symptoms.
  • Suggests that early diagnosis and dietary management of celiac disease can lead to neurological recovery.

Keywords:
acute malnutritionataxiadiarrheaextrapontine myelinolysisgluten

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