[Neuropsychological changes in coeliac disease]

Abstract

Objective: Coeliac disease is a gastrointestinal disorder caused by intolerance to cereals due to an immunological mechanism. The intestinal mucosa is damaged, causing a severe malabsorption syndrome. The diagnosis is based on classical clinical features such as diarrhoea and weight loss. However, there is a broad spectrum of this disorder which includes disorders of other organs and systems. In this paper we review the main studies of involvement of the nervous system in coeliac disease.

Development: Studies published to date report a high prevalence of ataxia, headaches and epilepsy, especially associated with bilateral occipital calcifications together with psychological features and psychiatric disorders including behavior change, depression, schizophrenia, autism, and disorders of personality, emotion and family relationships. Problems of learning and cognition are less common.

Conclusions: Many of these processes have only relatively recently been recognized. The pathogenic mechanism of these disorders is not completely clear although biochemical factors such as a low plasma serotonin level may be a cause. Treatment is based on the early recognition of the disorder which is difficult to suspect when there are no gastrointestinal symptoms present and the use of various types of treatment, including a cereal free diet, which is the most effective.