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The Gut-brain Axis: A New Pathogenic View of Neurologic Symptoms - Description of a Pediatric Case
Raffaele Falsaperla1, Catia Romano1, Piero Pavone1
1General Paediatrics Complex Operative Unit, Policlinico-Vittorio Emanuele University Hospital, University of Catania, Catania, Italy.
Insights
A cow's milk protein allergy in an infant caused drug-resistant epilepsy and GI issues. A milk-free diet resolved the seizures, highlighting the gut-brain axis in pediatric neurologic disorders.
Area of Science:
- Pediatric Neurology
- Gastroenterology
- Immunology
Background:
- Emerging research highlights the gut-brain axis, a bidirectional communication pathway between the gastrointestinal system and the central nervous system.
- Gastrointestinal (GI) disorders and neurologic diseases are increasingly recognized as interconnected, suggesting shared pathogenic mechanisms.
Observation:
- A 10-month-old infant presented with drug-resistant epilepsy, irritable behavior, and GI discomfort.
- The infant's symptoms were attributed to cow's milk protein allergy.
- Seizures, initially infrequent, escalated to 15-20 episodes daily, unresponsive to anticonvulsant therapies.
Findings:
- An accidental cow's milk protein-free diet, initiated during a gastroenteritis episode, completely resolved the infant's seizures.
- This case demonstrates a direct link between cow's milk protein allergy, GI inflammation, and refractory epilepsy in an infant.
Implications:
- The blood-brain barrier in infants under one year is particularly vulnerable to systemic inflammation.
- Neurologic manifestations in young children can be triggered by GI inflammation and food allergies.
- This case underscores the importance of considering the gut-brain axis in pediatric epilepsy management, especially in cases of food allergies.
Abstract:
Recent literature data have given emphasis to the relationship between gastrointestinal (GI) disorders and neurologic diseases, underlying a new pathogenic pathway: The so-called "gut-brain axis." Herein, authors report a case of a 10-month-old male infant, admitted for drug-resistant epilepsy, associated with irritable behavior and GI discomfort, secondary to cow's milk protein allergy. Seizures were described by parents as upward eye movements that were mostly deviated to the right and were associated with slight extension of his neck. They were infrequent at first, but had increased gradually during the course of 3 days (up to 15-20 times/day). No anticonvulsant therapy was effective. Only a cow's milk protein-free diet, accidentally started during a gastroenteritis episode, was effective in stopping seizures. Our case underlines the peculiar vulnerability of the blood-brain barrier under 1 year of age, for which children of this age group experience neurologic manifestations during episodes of systemic inflammation.
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