Dietary treatment of gluten ataxia

• Published in: Journal of neurology, neurosurgery and psychiatry Vol. 74; no. 9; pp. 1221 - 1224
• Main Authors: Hadjivassiliou, M, Davies-Jones, G A B, Sanders, D S, Grünewald, R A
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd 01.09.2003; BMJ; BMJ Publishing Group LTD; BMJ Group
• Subjects: Adult; Aged; Aged, 80 and over; Antibody Formation; Ataxia; Ataxia - diet therapy; Ataxia - etiology; Biological and medical sciences; Biopsy; Celiac disease; Diet; Disease; Diseases of the nervous system; Female; Food Hypersensitivity - complications; Food Hypersensitivity - diet therapy; Gluten; gluten ataxia; gluten sensitivity; gluten-free diet; Glutens - immunology; Glutens - pharmacology; Humans; Immunoglobulins; Male; Medical sciences; Middle Aged; Patient Compliance; Patients; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Small intestine; Treatment Outcome; Vitamin E; Human; Immunopathology; Nervous system diseases; Deficient diet; Antibody; Cerebral disorder; Diet therapy; Immunological investigation; Central nervous system disease; Gliadin; Ataxia; Evolution; Neurological disorder; Gluten
• ISSN: 0022-3050; 1468-330X
• DOI: 10.1136/jnnp.74.9.1221

Background: Gluten ataxia is an immune mediated disease, part of the spectrum of gluten sensitivity, and accounts for up to 40% of cases of idiopathic sporadic ataxia. No systematic study of the effect of gluten-free diet on gluten ataxia has ever been undertaken. Objective: To study the effect of gluten-free diet on patients presenting with ataxia caused by gluten sensitivity. Methods: 43 patients with gluten ataxia were studied. All were offered a gluten-free diet and monitored every six months. All patients underwent a battery of tests to assess their ataxia at baseline and after one year on diet. Twenty six patients (treatment group) adhered to the gluten-free diet and had evidence of elimination of antigliadin antibodies by one year. Fourteen patients refused the diet (control group). Three patients had persistently raised antigliadin antibodies despite adherence to the diet and were therefore excluded from the analysis. Results: After one year there was improvement in ataxia reflected in all of the ataxia tests in the treatment group. This was significant when compared with the control group. The diet associated improvement was apparent irrespective of the presence of an enteropathy. Conclusions: Gluten ataxia responds to a strict gluten-free diet even in the absence of an enteropathy. The diagnosis of gluten ataxia is vital as it is one of the very few treatable causes of sporadic ataxia.