Author/Authors :
casella, giovanni Medical Department - Desio Hospital - ASST Monza , Desio (Monza Brianza), Italy , santilli, ignazi Chief Neurology Department - Desio Hospital - ASST Monza, Desio (Monza Brianza), Italy , di bella, camillo Pathology Department - Carate Brianza Hospital - ASST Vimercate - Carate Brianza (Monza Brianza), Italy , crisafulli, valentina Institute of Pathology - Spedali Civili Brescia - ASST Spedali Civili Brescia - Brescia, Italy , villanacci, vincenzo Chief Medical Department - Desio Hospital - ASST Monza , Desio (Monza Brianza), Italy , baldini, vittorio Chief Medical Department - Desio Hospital - ASST Monza , Desio (Monza Brianza), Italy , bassotti, gabrio Gastroenterology and Hepatology Section - Department of Medicine - University of Perugia Medical School, Italy
Abstract :
Cerebellar ataxia (CA) is one of the most frequent neurological manifestations related to celiac disease (CD). Celiac disease is found in patients with a percentage ranging from 1.9% to 16.7%. Gluten cerebellar ataxia is purely cerebellar and involves the entire cerebel-lum. The clinical signs of CA are gait ataxia, limb ataxia, dysarthria, pyramidal signs, altered eyes motions, and progressive impair-ment of stability, and erect position. The patients a ected by Gluten CA show an immunological response against a primarily brain expressed TG, such as TG6. The prolonged gluten consumption in patients with gluten ataxia leads to a progressive loss of purk-inje cells in the cerebellum. An early diagnosis of CA and gluten related disorders (GRD) increases the possibility to improve the neurological process. Non celiac gluten sensitivity (NCGS) is defined by clinical evidence of improvement of symptoms following the introduction of GFD in the absence of enteropathy. The increased recognition of the whole spectrum of Gluten related disor-ders (GRD) is the best way to improve the time of the diagnosis and to avoid patients with neurological manifestation remaining untreated if duodenal biopsy does not reveal an enteropathy. Cerebellar Ataxia is equally responsive to GFD in CD and NCGS patients.
