Celiac Disease and Epilepsy: The Effect of Gluten-Free Diet on Seizure Control.

BACKGROUND Determining the true prevalence of celiac disease (CD) is difficult because of many atypical symptoms. Although CD primarily affects the gastrointestinal tract, patients may be asymptomatic or have extra intestinal symptoms. OBJECTIVES In this study, we assessed the prevalence of CD in patients with epilepsy and the effect of a gluten-free diet on seizure control in these patients. MATERIAL AND METHODS Patients with epilepsy in Imam Reza and Farabi Hospitals, Kermanshah, Iran, were studied. At first, the patients were screened by means of measuring the immunoglobulin A antiendomysial (IgA) antibodies. In the patients testing positive for IgA antibodies, 2-3 endoscopic small bowel biopsies were taken from the distal duodenum to confirm CD changes. People with CD received a gluten-free diet for 5 months and their seizure activity was recorded. RESULTS During the study period, we studied 113 patients with epilepsy. Seven patients (6%) were diagnosed with CD. After 5 months of instituting a gluten-free diet, in 6 patients seizures were completely under control and antiepileptic drugs were discontinued. In one case, anticonvulsant drugs were reduced by half and seizures were controlled. CONCLUSIONS Our results showed that about 6% of epileptic patients were positive for CD. Institution of a glutenfree diet is useful for seizure control in these patients.