Cerebellar Ataxia, Celiac Disease and Non-Celiac Gluten Sensitivity

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 cerebellum. The clinical signs of CA are gait ataxia, limb ataxia, dysarthria, pyramidal signs, altered eyes motions, and progressive impairment of stability, and erect position. The patients affected 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 purkinje 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 disorders (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.