Prevalence of celiac disease in Turkish children with idiopathic epilepsy

Abstract

Objective: This study has examined the prevalence of celiac disease in Turkish children with idiopathic epilepsy.

Methods: Children with idiopathic epilepsy were screened for celiac disease using the IgA anti-tissue transglutaminase antibody and compared with the healthy control group in order to find the association of celiac disease (CD) with idiopathic epilepsy. Upper gastrointestinal endoscopy and small intestinal biopsies were offered to all antibody-positive patients. Findings : A total of 214 children with the diagnosis of idiopathic epilepsy and 166 healthy children as control group were studied. Of the patients recruited, 55.1% had generalized epilepsy, and 44.9% had partial epilepsy. In 33 patients with partial epilepsy, electroclinical features were consistent with a diagnosis of childhood partial epilepsy with occipital paroxysms (CPEO). Two of 33 patients with CPEO had positive IgA anti-tissue transglutaminase antibodies in serology. Pathological examination of small intestinal biopsy specimens showed total villous atrophy in both of them. The prevalence of celiac disease among children with idiopathic epilepsy and CPEO was 0.9% and 6%, respectively.

Conclusion: The results of the present study revealed that prevalence of CD is increased in children with epilepsy. On the other hand, as high as 6% prevalence of CD among patients with CPEO found in this study should be kept in mind and the clinicians should be aware of this association.

Keywords: Celiac Disease; Epilepsy; Occipital Paroxysms.

Fig 1

Endoscopic view of distal duodenum of patients with celiac disease showing scalloping of folds and "cracked-mud" appearance to mucosa (a,b).

Fig 2

The microscopic views of the distal duodenal biopsy specimens in patients with celiac disease (a,b). Note the characteristic features of blunting of villi, crypt hyperplasia, and increased intraepithelial lymphocytes of crypts (Hematoxylin and eosin stain, 200×).