Occipital Epilepsy With Subcortical Atrophy in Celiac Disease: A Case Report
Alionka Bostan1, Chiara Mabiglia1, Adraa Nouini1
1Department of Neurology (AB, AN, HV, B. Dachy), Brugmann University Hospital; Neuroradiology Clinic (CM), Medical Imaging Department, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium; and Inkendaal Rehabilitation Hospital and Université Libre de Bruxelles (B. Dan).
Abstract:
We report a 50-year-old man with celiac disease who presented with occipital epilepsy. Brain MRI showed right occipital subcortical white matter hyperintensities, consistent with the posterior epileptic focus suggested by the clinical features of the seizures and documented on EEG. Shortly after the introduction of a gluten-free diet, the white matter abnormalities resolved. The patient went on to develop simultagnosia. Follow-up MRI showed right occipital lobe atrophy. This report emphasizes the importance of recognizing gluten-associated neurologic manifestations and usefulness of thegluten-free diet.
Insights
Celiac disease can cause occipital epilepsy and white matter changes. A gluten-free diet resolved these abnormalities, highlighting the importance of recognizing gluten-associated neurological issues.
Area of Science:
- Neurology
- Gastroenterology
- Neuroimmunology
Background:
- Celiac disease is an autoimmune disorder triggered by gluten ingestion.
- Neurological manifestations are increasingly recognized in celiac disease.
- Occipital epilepsy is a rare presentation of celiac disease.
Observation:
- A 50-year-old male with celiac disease presented with occipital epilepsy.
- Brain MRI revealed right occipital subcortical white matter hyperintensities correlating with seizure focus on EEG.
- The patient developed simultagnosia, a visual attention deficit.
Findings:
- Introduction of a gluten-free diet led to the resolution of white matter abnormalities.
- Follow-up MRI demonstrated right occipital lobe atrophy despite dietary intervention.
- This case illustrates a direct link between gluten intake and neurological dysfunction.
Implications:
- Early recognition of gluten-associated neurological disorders is crucial for timely intervention.
- A gluten-free diet can be an effective treatment for certain neurological complications of celiac disease.
- Further research is warranted to understand the mechanisms underlying gluten-induced encephalopathy.
