Neurological Manifestations of Celiac Disease

  • Ehsan Pishva School for Mental Health and Neuroscience, Maastricht University, Maastricht
  • Afshin Borhani Haghighi Department of Neurology, Medical School, Shiraz University of medical sciences, Shiraz
  • Soheil Ashkani-Esfahani Student research committee, Shiraz University of Medical Sciences, Shiraz
  • Fereshte Bagheri Student research committee, Shiraz University of Medical Sciences, Shiraz
  • Ali Asghar Karimi Student research committee, Fasa University of medical sciences, Shiraz, Iran
  • Reza Malekzadeh Digestive Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran
Keywords: Celiac Disease, Nervous system, malabsorption syndrome, Review


Celiac disease (CD) is a rare malabsorption syndrome mainly occurring in childhood which is now recognized as the most common food intolerance disease in the world. CD is associated with a wide spectrum of extra intestinal manifestations. Neurological involvements of CD were first attributed to malabsorption due to changes in the mucosal architecture of the small intestine. Neurological manifestations were more frequent in middle-aged adults, but were rare in children. The most common central nervous system manifestations include cerebellar malfunctions, seizures, dementia, multiple sclerosis like presentations, motor neuron diseases, headaches, movement disorders, and neuro-psychiatric presentations. On the other hand, the peripheral nervous system involvement includes different types of peripheral neuropathies and muscular involvements. In this study, we embarked on a short review to go through the neurological presentations and problems of CD.

Author Biography

Soheil Ashkani-Esfahani, Student research committee, Shiraz University of Medical Sciences, Shiraz
Manager of research department, Student research committee of Shiraz university of medical sciencesDeputy editorCopy editor


Di Sabatino A, Corazza GR. Coeliac disease. Lancet. 2009;373(9673):1480-93.

Green PH, Cellier C. Celiac disease. N Engl J Med. 2007;357(17):1731-43.

Ludvigsson JF, Leffler DA, Bai JC, Biagi F, Fasano A, Green PH, et al. The Oslo definitions for coeliac disease and related terms. Gut. 2013;62:43–52.

Malekzadeh R, Sachdev A, Fahid Ali A. Coeliac disease in developing countries: Middle East, India and North Africa. Best Pract Res Clin Gastroenterol. 2005;19(3):351-8.

Megiorni F, Mora B, Bonamico M, Barbato M, Nenna R, Maiella G, et al. HLA-DQ and risk gradient for celiac disease. Hum Immunol. 2009;70(1):55-9.

Malekzadeh R, Akbari MR. Prevalence of gluten-sensitive enteropathy and coeliac disease in Iran. Eur J Gastroenterol Hepatol. 2007;19(9):825-6.

2001. RoawgotUEGWiA. When is a coeliac a coeliac? Eur J Gastroenterol Hepatol. 2001;13:1123-8.

Wahaba PJ, Crusiusc JB, Meijerb WR, Mulder CJ. Gluten challenge in borderline gluten-sensitive enteropathy. The American Journal of Gastroenterology. 2001;96(5):1464-9.

Hopper AD, Hadjivassiliou M, Butt S, Sanders DS. Adult coeliac disease. BMJ. 2007;335(7619):558-62.

Katz KD, Rashtak S, Lahr BD, Melton J, Krause PK, Maggi K, et al. Screening for celiac disease in a North American population: sequential serology and gastrointestinal symptoms. Am J Gastroenterology. 2011;106:1333-9.

Freeman HJ. Risk factors in familial forms of celiac disease. World J Gastroenterol. 2010;16:1828-31.

Newnham ED. Does gluten cause gastrointestinal symptoms in subjects without coeliac disease? J Gastroenterol Hepatol. 2011;26(3):132-4.

Biesiekierski JR, Newnham ED, Irving PM, Barrett JS, Haines M, Doecke JD, et al. Gluten causes gastrointestinal symptoms in subjects without celiac disease: a double-blind randomized placebo-controlled trial. Am J Gastroenterol. 2011;106:508-14.

Cascella NG, Kryszak D, Bhatti B, Gregory P, Kelly DL, Mc Evoy JP, et al. Prevalence of celiac disease and gluten sensitivity in the United States clinical antipsychotic trials of intervention effectiveness study population. Schizophr Bull. 2011;37:94-100.

Brown WC. Sprue and Its Treatment. London: Bale and Danielsson; 1908.

Elders C. Tropical sprue and pernicious anaemia, aetiology and treatment. . Lancet. 1925;1:75-7.

Cooke WT, Smith WT. Neurological disorders associated with adult coeliac disease. Brain. 1966;89(4):683-722.

Robinson K. Wernicke's encephalopathy. Emerg Nurse. 2003;11(5):30-3.

Marks J, Shuster S, Watson AJ. Small-bowel changes in dermatitis herpetiformis. Lancet. 1966;2(7476):1280-2.

Wills AJ, Turner B, Lock RJ, Johnston SL, Unsworth DJ, Fry L. Dermatitis herpetiformis and neurological dysfunction. J Neurol Neurosurg Psychiatry. 2002;72(2):259-61.

Finelli PF, McEntee WJ, Ambler M, Kestenbaum D. Adult celiac disease presenting as cerebellar syndrome. Neurology. 1980;30(3):245-9.

Banerji NK, Hurwitz LJ. Neurological manifestations in adult steatorrhoea (probable Gluten enteropathy). J Neurol Sci. 1971;14(2):125-41.

Luostarinen L, Pirttila T, Collin P. Coeliac disease presenting with neurological disorders. Eur Neurol. 1999;42(3):132-5.

Pengiran Tengah DS, Wills AJ, Holmes GK. Neurological complications of coeliac disease. Postgrad Med J. 2002;78(921):393-8.

Volta U, De Giorgio R, Petrolini N, Stangbellini V, Barbara G, Granito A, et al. Clinical findings and anti-neuronal antibodies in coeliac disease with neurological disorders. Scand J Gastroenterol. 2002;37(11):1276-81.

Vaknin A, Eliakim R, Ackerman Z, Steiner I. Neurological abnormalities associated with celiac disease. J Neurol. 2004;251(11):1393-7.

Zelnik N, Pacht A, Obeid R, Lerner A. Range of neurologic disorders in patients with celiac disease. Pediatrics. 2004;113(6):1672-6.

Briani C, Samaroo D, Alaedini A. Celiac disease: from gluten to autoimmunity. Autoimmun Rev. 2008;7(8):644-50.

Hadjivassiliou M, Grunewald RA, Davies-Jones GA. Gluten sensitivity as a neurological illness. J Neurol Neurosurg Psychiatry. 2002;72(5):560-3.

Bushara KO. Neurologic presentation of celiac disease. Gastroenterology. 2005;128(1):92-7.

Lionetti E, Francavilla R, Pavone P, Pavone L, Francavilla T, Pulvirenti A, et al. The neurology of coeliac disease in childhood: what is the evidence? A systematic review and meta-analysis. Developmental Medicine and Childhood Neurology. 2010;52:700-7.

Hadjivassiliou M, Grunewald RA, Chattopadhyay AK, Davies-Jones GA, Gibson A, Jarratt JA, et al. Clinical, radiological, neurophysiological, and neuropathological characteristics of gluten ataxia. Lancet. 1998;352(9140):1582-5.

Bhatia KP, Brown P, Gregory R, Lennox GG, Manji H, Thompson PD, et al. Progressive myoclonic ataxia associated with coeliac disease. The myoclonus is of cortical origin, but the pathology is in the cerebellum. Brain. 1995;118 ( Pt 5):1087-93.

Shams PN, Waldman A, Dogan A, MacKenzie JM, Plant GT. Ataxia in the setting of complicated enteropathy: double jeopardy. J Neurol Neurosurg Psychiatry. 2002;72(4):527-9.

Hadjivassiliou M, Maki M, Sanders DS, Williamson CA, Grunewald RA, Woodroofe NM, et al. Autoantibody targeting of brain and intestinal transglutaminase in gluten ataxia. Neurology. 2006;66(3):373-7.

Hadjivassiliou M, Grunewald RA, Lawden M, Davies-Jones GA, Powell T, Smith CM. Headache and CNS white matter abnormalities associated with gluten sensitivity. Neurology. 2001;56(3):385-8.

Alaedini A, Green PH, Sander HW, Hays AP, Gamboa ET, Fasano A, et al. Ganglioside reactive antibodies in the neuropathy associated with celiac disease. J Neuroimmunol. 2002;127(1-2):145-8.

Chin RL, Sander HW, Brannagan TH, Green PH, Hays AP, Alaedini A, et al. Celiac neuropathy. Neurology. 2003;60(10):1581-5.

Luostarinen L, Himanen SL, Luostarinen M, Collin P, Pirttila T. Neuromuscular and sensory disturbances in patients with well treated coeliac disease. J Neurol Neurosurg Psychiatry. 2003;74(4):490-4.

Silano M, Vincentini O, Luciani A, Felli C, Caserta S, Esposito S, et al. Early tissue transglutaminase-mediated response underlies K562(S)-cell gliadin-dependent agglutination. Pediatr Res. 2012;71:532-8.

Hadjivassiliou M, Boscolo S, Davies-Jones GA, Grunewald RA, Not T, Sanders DS, et al. The humoral response in the pathogenesis of gluten ataxia. Neurology. 2002;58(8):1221-6.

Lauriere M, Bouchez I, Doyen C, Eynard L. Identification of glycosylated forms of wheat storage proteins using two-dimensional electrophoresis and blotting. Electrophoresis. 1996;17(3):497-501.

Alaedini A, Okamoto H, Briani C, Wollenberg K, Shill HA, Bushara KO, et al. Immune cross-reactivity in celiac disease: anti-gliadin antibodies bind to neuronal synapsin I. J Immunol. 2007;178(10):6590-5.

Kaida K, Ariga T, Yu RK. Antiganglioside antibodies and their pathophysiological effects on Guillain-Barre syndrome and related disorders-a review. Glycobiology. 2009;19(7):676-92.

Sollid LM, Molberg O, McAdam S, Lundin KE. Autoantibodies in coeliac disease: tissue transglutaminase--guilt by association? Gut. 1997;41(6):851-2.

Hadjivassiliou M, Grunewald R, Sharrack B, Sanders D, Lobo A, Williamson C, et al. Gluten ataxia in perspective: epidemiology, genetic susceptibility and clinical characteristics. Brain. 2003;126(3):685-91.

Deconinck N, Scaillon M, Segers V, Groswasser JJ, Dan B. Opsoclonus-myoclonus associated with celiac disease. Pediatr Neurol. 2006;34(4):312-4.

Green PH, Alaedini A, Sander HW, Brannagan TH, Latov N, Chin RL. Mechanisms underlying celiac disease and its neurologic manifestations. Cell Mol Life Sci. 2005;62(7-8):791-9.

Shill HA, Alaedini A, Bushara KO, Latov N, Hallett M. Anti-ganglioside antibodies in idiopathic and hereditary cerebellar degeneration. Neurology. 2003;60(10):1672-3.

Almaguer-Mederos LE, Almira YR, Gongora EM, Gotay DA, Zaldivar YG, Pupo RE, et al. Antigliadin antibodies in Cuban patients with spinocerebellar ataxia type 2. J Neurol Neurosurg Psychiatry. 2008;79(3):315-7.

Ihara M, Makino F, Sawada H, Mezaki T, Mizutani K, Nakase H, et al. Gluten sensitivity in Japanese patients with adult-onset cerebellar ataxia. Intern Med. 2006;45(3):135-40.

Hadjivassiliou M, Sanders DS, Grunewald RA, Woodroofe N, Boscolo S, Aeschlimann D. Gluten sensitivity: from gut to brain. Lancet Neurol. 2010;9(3):318-30.

Combarros O, Infante J, Lopez-Hoyos M, Bartolome MJ, Berciano J, Corral J, et al. Celiac disease and idiopathic cerebellar ataxia. Neurology. 2000;54(12):2346.

Lock RJ, Pengiran Tengah DS, Unsworth DJ, Ward JJ, Wills AJ. Ataxia, peripheral neuropathy, and anti-gliadin antibody. Guilt by association? J Neurol Neurosurg Psychiatry. 2005;76(11):1601-3.

Wong D, Dwinnel M, Schulzer M, Nimmo M, Leavitt BR, Spacey SD. Ataxia and the role of antigliadin antibodies. Can J Neurol Sci. 2007;34(2):193-6.

Gobbi G, Ambrosetto P, Zaniboni MG, Lambertini A, Ambrosioni G, Tassinari CA. Celiac disease, posterior cerebral calcifications and epilepsy. Brain Dev. 1992;14(1):23-9.

Pfaender M, D'Souza WJ, Trost N, Litewka L, Paine M, Cook M. Visual disturbances representing occipital lobe epilepsy in patients with cerebral calcifications and coeliac disease: a case series. J Neurol Neurosurg

Psychiatry. 2004;75(11):1623-5.

Pengiran Tengah CD, Lock RJ, Unsworth DJ, Wills AJ. Multiple sclerosis and occult gluten sensitivity. Neurology. 2004;62(12):2326-7.

Hadjivassiliou M, Sanders DS, Grunewald RA. Multiple sclerosis and occult gluten sensitivity. Neurology. 2005;64(5):933-4.

Borhani Haghighi A, Ansari N, Mokhtari M, Geramizadeh B, Lankarani KB. Multiple sclerosis and gluten sensitivity. Clin Neurol Neurosurg. 2007;109(8):651-3.

Nicoletti A, Patti F, Lo Fermo S, Sciacca A, Laisa P, Liberto A, et al. Frequency of celiac disease is not increased among multiple sclerosis patients. Mult Scler. 2008;14(5):698-700.

Shor DB, Barzilai O, Ram M, Izhaky D, Porat-Katz BS, Chapman J, et al. Gluten sensitivity in multiple sclerosis: experimental myth or clinical truth? Ann N Y Acad Sci. 2009;1173:343-9.

Bergamaschi R, Jarius S, Robotti M, Pichiecchio A, Wildemann B, Meola G. Two cases of benign neuromyelitis optica in patients with celiac disease. J Neurol. 2009;256(12):2097-9.

Jarius S, Jacob S, Waters P, Jacob A, Littleton E, Vincent A. Neuromyelitis optica in patients with gluten sensitivity associated with antibodies to aquaporin-4. J Neurol Neurosurg Psychiatry. 2008;79(9):1084.

Alehan F, Ozcay F, Erol I, Canan O, Cemil T. Increased risk for coeliac disease in paediatric patients with migraine. Cephalalgia. 2008;28(9):945-9.

Gabrielli M, Cremonini F, Fiore G, Addolorato G, Padalino C, Candelli M, et al. Association between migraine and Celiac disease: results from a preliminary case-control and therapeutic study. Am J Gastroenterol. 2003;98(3):625-9.

Lionetti E, Francavilla R, Maiuri L, Ruggieri M, Spina M, Pavone P, et al. Headache in pediatric patients with celiac disease and its prevalence as a diagnostic clue. J Pediatr Gastroenterol Nutr. 2009;49(2):202-7.

Roche Herrero MC, Arcas Martinez J, Martinez-Bermejo A, Lopez Martin V, Polanco I, Tendero Gormaz A, et al. [The prevalence of headache in a population of patients with coeliac disease]. Rev Neurol. 2001;32(4):301-9.

Cicarelli G, Della Rocca G, Amboni M, Ciacci C, Mazzacca G, Filla A, et al. Clinical and neurological abnormalities in adult celiac disease. Neurol Sci. 2003;24(5):311-7.

Spina M, Incorpora G, Trigilia T, Branciforte F, Franco G, Di Gregorio F. Headache as atypical presentation of celiac disease: report of a clinical case. Pediatr Med Chir. 2001;23:133-5.

Hu WT, Murray JA, Greenaway MC, Parisi JE, Josephs KA. Cognitive impairment and celiac disease. Arch Neurol. 2006;63(10):1440-6.

Lurie Y, Landau DA, Pfeffer J, Oren R. Celiac disease diagnosed in the elderly. J Clin Gastroenterol. 2008;42(1):59-61.

Frisoni GB, Carabellese N, Longhi M, Geroldi C, Bianchetti A, Govoni S, et al. Is celiac disease associated with Alzheimer's disease? Acta Neurol Scand. 1997;95(3):147-51.

Hallert C, Astrom J. Intellectual ability of adults after lifelong intestinal malabsorption due to coeliac disease. J Neurol Neurosurg Psychiatry. 1983;46(1):87-9.

Burk K, Farecki ML, Lamprecht G, Roth G, Decker P, Weller M, et al. Neurological symptoms in patients with biopsy proven celiac disease. Mov Disord. 2009;24(16):2358-62.

Hallert C, Derefeldt T. Psychic disturbances in adult coeliac disease. I. Clinical observations. Scand J Gastroenterol. 1982;17(1):17-9.

Pavone L, Fiumara A, Bottaro G, Mazzone D, Coleman M. Autism and celiac disease: failure to validate the hypothesis that a link might exist. Biol Psychiatry. 1997;42(1):72-5.

West J, Logan RF, Hubbard RB, Card TR. Risk of schizophrenia in people with coeliac disease, ulcerative colitis and Crohn's disease: a general population-based study. Aliment Pharmacol Ther. 2006;23(1):71-4.

Batista IC, Gandolfi L, Nobrega YK, Almeida RC, Almeida LM, Junior DC, et al. Autism spectrum disorder and celiac disease: no evidence for a link. Arq Neuropsiquiatr. 2012;70:28-33.

Millward C, Ferriter M, Calver S, Connell-Jones G. Gluten- and casein-free diets for autistic spectrum disorder. Cochrane Database Syst Rev. 2004;(2).

Buie T, Campbell DB, Fuchs GJ, Furuta GT, Levy J, VandeWater J, et al. Evaluation, diagnosis, and treatment of gastrointestinal disorders in individuals with ASDs: a consensus report. Pediatrics. 2010;125(1):1-18.

Ibrahim SH, Voigt RG, Katusic SK, Weaver AL, Barbaresi WJ. Incidence of gastrointestinal symptoms in children with autism: A population-based study. Pediatrics. 2009;124:680-6.

Hall DA, Parsons J, Benke T. Paroxysmal nonkinesigenic dystonia and celiac disease. Mov Disord. 2007;22(5):708-10.

Nanji AA, Freeman HJ, Anderson FH. Paralysis and rhabdomyolysis: a presenting feature of celiac disease. West J Med. 1982;136(3):273-4.

Kitiyakara T, Jackson M, Gorard DA. Refractory coeliac disease, small-bowel lymphoma and chorea. J R Soc Med. 2002;95(3):133-4.

Pereira AC, Edwards MJ, Buttery PC, Hawkes CH, Quinn NP, Giovannoni G, et al. Choreic syndrome and coeliac disease: a hitherto unrecognised association. Mov Disord. 2004;19(4):478-82.

Leggio L, Cadoni G, D'Angelo C, Mirijello A, Scipione S, Ferrulli A, et al. Coeliac disease and hearing loss: preliminary data on a new possible association. Scand J Gastroenterol. 2007;42(10):1209-13.

Volta U, Ferri GG, De Giorgio R, Fabbri A, Parisi C, Sciajno L, et al. Sensorineural hearing loss and celiac disease: a coincidental finding. Can J Gastroenterol. 2009;23(8):531-5.

Goodwin FC, Beattie RM, Millar J, Kirkham FJ. Celiac disease and childhood stroke. Pediatr Neurol. 2004;31(2):139-42.

Audia S, Duchene C, Samson M, Muller G, Bielefeld P, Ricolfi F, et al. Stroke in young adults with celiac disease. Rev Med Interne. 2008;29(3):228-31.

Di Lazzaro V, Pilato F, Batocchi AP, Restuccia D, Cammarota G, Profice P. Tired legs--a gut diagnosis. Lancet. 2010;376(9754):1798.

Goodman BP, Mistry DH, Pasha SF, Bosch PE. Copper deficiency myeloneuropathy due to occult celiac disease. Neurologist. 2009;15(6):355-6.

Murinson BB. Stiff-Person Syndrome. Neurologist. 2004;10 (3):131-7.

Kelkar P, Ross MA, Murray J. Mononeuropathy multiplex associated with celiac sprue. Muscle Nerve. 1996;19(2):234-6.

Brannagan TH, Hays AP, Chin SS, Sander HW, Chin RL, Magda P, et al. Small-fiber neuropathy/neuronopathy associated with celiac disease: skin biopsy findings. Arch Neurol. 2005;62(10):1574-8.

Ludvigsson JF, Olsson T, Ekbom A, Montgomery SM. A population-based study of coeliac disease, neurodegenerative and neuroinflammatory diseases. Aliment Pharmacol Ther. 2007;25(11):1317-27.

Hadjivassiliou M, Grunewald RA, Kandler RH, Chattopadhyay AK, Jarratt JA, Sanders DS, et al. Neuropathy associated with gluten sensitivity. J Neurol Neurosurg Psychiatry. 2006;77(11):1262-6.

Selva-O'Callaghan A, Casellas F, de Torres I, Palou E, Grau-Junyent JM, Vilardell-Tarres M. Celiac disease and antibodies associated with celiac disease in patients with inflammatory myopathy. Muscle Nerve. 2007;35(1):49-54.

Hadjivassiliou M, Chattopadhyay AK, Grunewald RA, Jarratt JA, Kandler RH, Rao DG, et al. Myopathy associated with gluten sensitivity. Muscle Nerve. 2007;35(4):443-50.

Alawneh K, Ashley C, Carlson JA. Neutrophilic myositis as a manifestation of celiac disease: a case report. Clin Rheumatol. 2008;27(1):11-3.

Marie I, Lecomte F, Hachulla E, Antonietti M, Francois A, Levesque H, et al. An uncommon association: celiac disease and dermatomyositis in adults. Clin Exp Rheumatol. 2001;19(2):201-3.

Hadjivassiliou M, Chattopadhyay AK, Davies-Jones GA, Gibson A, Grunewald RA, Lobo AJ. Neuromuscular disorder as a presenting feature of coeliac disease. J Neurol Neurosurg Psychiatry. 1997;63(6):770-5.

Burk K, Bosch S, Muller CA, Melms A, Zuhlke C, Stern M, et al. Sporadic cerebellar ataxia associated with gluten sensitivity. Brain. 2001;124(5):1013-9.

Pellecchia MT, Scala R, Filla A, De Michele G, Ciacci C, Barone P. Idiopathic cerebellar ataxia associated with celiac disease: lack of distinctive neurological features. J Neurol Neurosurg Psychiatry. 1999;66(1):32-5.

Hadjivassiliou M, Gibson A, Davies-Jones GA, Lobo AJ, Stephenson TJ, Milford-Ward A. Does cryptic gluten sensitivity play a part in neurological illness? Lancet. 1996;347(8998):369-71.

Hadjivassiliou M, Aeschlimann P, Strigun A, Sanders DS, Woodroofe N, Aeschlimann D. Autoantibodies in gluten ataxia recognize a novel neuronal transglutaminase. Ann Neurol. 2008;64(3):332-43.

Bushara KO, Nance M, Gomez CM. Antigliadin antibodies in Huntington's disease. Neurology. 2004;62(1):132-3.

Ghezzi A, Filippi M, Falini A, Zaffaroni M. Cerebral involvement in celiac disease: a serial MRI study in a patient with brainstem and cerebellar symptoms. Neurology. 1997;49(5):1447-50.

Siqueira Neto JI, Costa AC, Magalhaes FG, Silva GS. Neurological manifestations of celiac disease. Arq Neuropsiquiatr. 2004;62(4):969-72.

Chinnery PF, Reading PJ, Milne D, Gardner-Medwin D, Turnbull DM. CSF antigliadin antibodies and the Ramsay Hunt syndrome. Neurology. 1997;49(4):1131-3.

Muller AF, Donnelly MT, Smith CM, Grundman MJ, Holmes GK, Toghill PJ. Neurological complications of celiac disease: a rare but continuing problem. Am J Gastroenterol. 1996;91(7):1430-5.

Hadjivassiliou M, Kandler RH, Chattopadhyay AK, Davies-Jones AG, Jarratt JA, Sanders DS, et al. Dietary treatment of gluten neuropathy. Muscle Nerve. 2006;34(6):762-6.

Molteni N, Bardella MT, Baldassarri AR, Bianchi PA. Celiac disease associated with epilepsy and intracranial calcifications: report of two patients. Am J Gastroenterol. 1988;83(9):992-4.

Hernandez MA, Colina G, Ortigosa L. Epilepsy, cerebral calcifications and clinical or subclinical coeliac disease. Course and follow up with gluten-free diet. Seizure. 1998;7(1):49-54.

Canales P, Mery VP, Larrondo FJ, Bravo FL, Godoy J. Epilepsy and celiac disease: favorable outcome with a gluten-free diet in a patient refractory to antiepileptic drugs. Neurologist. 2006;12(6):318-21.

Pratesi R, Modelli IC, Martins RC, Almeida PL, Gandolfi L. Celiac disease and epilepsy: favorable outcome in a child with difficult to control seizures. Acta Neurol Scand. 2003;108:290-3.

Addolorato G, Stefanini GF, Capristo E, Caputo F, Gasbarrini A, Gasbarrini G. Anxiety and depression in adult untreated celiac subjects and in patients affected by inflammatory bowel disease: a personality "trait" or a reactive illness? Hepatogastroenterology. 1996;43(12):1513-7.

Brown KJ, Jewells V, Herfarth H, Castillo M. White Matter Lesions Suggestive of Amyotrophic Lateral Sclerosis Attributed to Celiac Disease. AJNR Am J Neuroradiol. 2010;31(5):880-1.

Russell JA. Osteomalacic myopathy. Muscle Nerve. 1994;17(6):578-80.

Ward ME, Murphy JT, Greenberg GR. Celiac disease and spinocerebellar degeneration with normal vitamin E status. Neurology. 1985;35(8):1199-201.

Souayah N, Chin RL, Brannagan TH, Latov N, Green PH, Kokoszka A, et al. Effect of intravenous immunoglobulin on cerebellar ataxia and neuropathic pain associated with celiac disease. Eur J Neurol. 2008;15(12):1300-3.

Nanri K, Otsuka T, Takeguchi M, Taguchi T, Ishiko T, Mitoma H, et al. A case of anti-gliadin-antibody-positive cerebellar ataxia effectively treated with intravenous immunoglobulin in which voxel-based morphometry and FineSRT were diagnostically useful. Rinsho Shinkeigaku. 2009;49(1):37-42.

Nanri K, Okita M, Takeguchi M, Taguchi T, Ishiko T, Saito H, et al. Intravenous immunoglobulin therapy for autoantibody-positive cerebellar ataxia. Intern Med. 2009;48(10):783-90.

Ait Ben Haddou E, Errabih I, Raissouni L, Elhassani M, Benomar A, Ouazzani H, et al. Interest of corticosteroids in neurological complications of celiac disease. Rev Neurol (Paris). 2009;165(12):1103-6.

Chaudhry V, Ravich WJ. Other neurological disorders associated with gastrointestinal, liver, or pancreatic diseases. Neurology and General Medicine. 3th ed. . Churchill Livingston. 2001:283-4.

How to Cite
Pishva, E., Borhani Haghighi, A., Ashkani-Esfahani, S., Bagheri, F., Karimi, A. A., & Malekzadeh, R. (2013). Neurological Manifestations of Celiac Disease. Galen Medical Journal, 2(2), 60-75.
Review Article