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Gluten sensitivity and epilepsy: a systematic review.

Thomas Julian1, Marios Hadjivassiliou2, Panagiotis Zis2

  • 1Sheffield Institute for Translational Neuroscience, University of Sheffield, 385a Glossop Rd, Sheffield, S10 2HQ, UK. thjulian07@gmail.com.

Journal of Neurology
|September 1, 2018
PubMed
Summary

Epilepsy is more common in individuals with coeliac disease (CD) and vice versa. Investigating gluten sensitivity in epilepsy patients may lead to improved outcomes with a gluten-free diet (GFD).

Keywords:
CDCECCeliacCoeliacEpilepsyGluten

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Area of Science:

  • Neurology
  • Gastroenterology
  • Immunology

Background:

  • Coeliac disease (CD) and gluten sensitivity (GS) are increasingly recognized conditions.
  • The relationship between gluten-related disorders and neurological conditions like epilepsy is not fully understood.
  • Understanding the prevalence and characteristics of epilepsy in CD/GS patients is crucial for diagnosis and management.

Purpose of the Study:

  • To determine the prevalence of epilepsy in patients with CD or GS, and vice versa.
  • To characterize the specific epileptic syndromes observed in these patient populations.
  • To evaluate the potential benefits of a gluten-free diet (GFD) in managing epilepsy associated with gluten-related disorders.

Main Methods:

  • A systematic literature search was performed on the PubMed database.
  • Data extraction focused on prevalence, demographics, and epilepsy phenomenology.
  • Analysis included comparing prevalence rates between patient groups and the general population.

Main Results:

  • Epilepsy is 1.8 times more prevalent in CD patients; CD is over 2 times more prevalent in epilepsy patients.
  • Elevated prevalence of CD/GS was noted in specific epilepsy types: childhood partial epilepsy with occipital paroxysms, adult fixation off sensitivity (FOS), and temporal lobe epilepsy (TLE) with hippocampal sclerosis.
  • A notable association is the Coeliac disease, Epilepsy, and Cerebral calcification (CEC) syndrome.
  • A gluten-free diet (GFD) was effective in managing epilepsy in 53% of cases, reducing seizure frequency or medication needs.

Conclusions:

  • Patients with unexplained epilepsy should be screened for gluten sensitivity.
  • Early investigation for CD/GS may benefit patients with epilepsy, particularly those with specific seizure presentations.
  • A GFD can be an effective therapeutic strategy for epilepsy in individuals with gluten-related disorders.