Improvement in Chronic Muscle Fasciculations With Dietary Change: A Suspected Case of Gluten Neuropathy

Abstract

ObjectiveThe purpose of this case report is to describe a patient with chronic, multisite muscle fasciculations who presented to a chiropractic teaching clinic and was treated with dietary modifications. Clinical featuresA 28-year-old man had muscle fasciculations of 2 years. The fasciculations began in his eye and progressed to the lips and lower extremities. In addition, he had gastrointestinal distress and fatigue. The patient was previously diagnosed as having wheat allergy at the age of 24 but was not compliant with a gluten-free diet at that time. Food sensitivity testing revealed immunoglobulin G–based sensitivity to multiple foods, including many different grains and dairy products. The working diagnosis was gluten neuropathy. Intervention and outcomeWithin 6 months of complying with dietary restrictions based on the sensitivity testing, the patient’s muscle fasciculations completely resolved. The other complaints of brain fog, fatigue, and gastrointestinal distress also improved. ConclusionsThis report describes improvement in chronic, widespread muscle fasciculations and various other systemic symptoms with dietary changes. There is strong suspicion that this case represents one of gluten neuropathy, although testing for celiac disease specifically was not performed.