Neurologic manifestations of celiac disease: proven, or just a gut feeling?

Celiac disease (celiac sprue or gluten-sensitive enteropathy) is an inflammatory autoimmune disease of the small intestine that occurs in genetically susceptible (HLA DQ2 or DQ8 ) individuals upon exposure to dietary gluten.1 Gluten (gliadin and glutenin, found in wheat, rye, and barley) comprises a family of prolineand glutamine-rich proteins. Celiac disease is common, affecting 0.5 to 1% of the Caucasian population, but incidence varies in different races. Classic symptoms, including chronic diarrhea and malabsorption, may occur in children or adults, but patients may be completely asymptomatic despite positive antibody and biopsy tests. Treatment with a strict, gluten-free diet results in cessation of gastrointestinal symptoms and normalization of antibody titers.