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    Myoclonus Ataxia and Refractory Celiac Disease

    Reviewed and edited by a celiac disease expert.
    Myoclonus Ataxia and Refractory Celiac Disease - Photo: Wikimedia Commons--Stan Zurek
    Caption: Photo: Wikimedia Commons--Stan Zurek

    Celiac.com 10/27/2014 - There have been a few reports tying cortical myoclonus with ataxia to celiac disease. Such reports also suggest that the former is unresponsive to a gluten-free diet.

    A team of researchers recently set out to determine if there is any significant connection between the two conditions. The research team included Ptolemaios G. Sarrigiannis, Nigel Hoggard, Daniel Aeschlimann, David S. Sanders, Richard A. Grünewald, Zoe C. Unwin, and Marios Hadjivassiliou.

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    They are variously associated with the Departments of Gastroenterology, Neurology, Neurophysiology and Neuroradiology at Royal Hallamshire Hospital, in Sheffield, UK, and with the College of Biomedical and Life Sciences at Cardiff University in Cardiff, UK.

    The team presented detailed electro-clinical characteristics of a new syndrome of progressive cortical hyperexcitability with ataxia and refractory celiac disease. Regular follow ups of over 600 patients with neurological manifestations due to gluten sensitivity revealed 9 patients with this syndrome.

    They found that all nine patients, six men and three women, experienced asymmetrical irregular myoclonus involving one or more limbs and sometimes face. This was often stimulus sensitive and became more widespread over time. Three patients had a history of Jacksonian march, and five had at least one secondarily generalized seizure. Electrophysiology showed evidence of cortical myoclonus. Three showed a phenotype of epilepsia partialis continua at onset.

    All patients showed clinical, imaging and/or pathological evidence of cerebellar involvement. All patients followed a strict gluten-free diet, and most successfully eliminated gluten-related antibodies. However, all patients still showed evidence of enteropathy, suggests that refractory celiac disease is to blame.

    During the study, two patients died from enteropathy-associated lymphoma and one from status epilepticus. Five patients were treated with mycophenolate and one in addition with rituximab and IV immunoglobulins. These patients showed improvement of ataxia and enteropathy, but continued to suffer the effects of myoclonus.

    These results indicate that myoclonus ataxia might be the most common neurological manifestation of refractory celiac disease.

    The clinical involvement, apart from ataxia, covers the whole clinical spectrum of cortical myoclonus.

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    Guest Irv

    Very interesting.

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    Dawn Meyers

    Hi I have been gluten free since 2017 when diagnosed with celiac disease.  My blood test IgA was off the chart also have dermatitis herpetiformis rash. I have continued to have diarrhea and have had nausea also. Have had breath tests but came back with intolerance to sugar alcohols and chicory root. Have taken out of diet but still have diarrhea and nausea. My blood was taken IgA and is even higher than before. Recently was told my other rash is psoriasis and a positive for psoriasis arthritis.  Having  iching and burning in arms and legs with no rash worse when go to bed. My concern is if I have refractory celiac? My dad had non-hogins lymphoma and I know that cancer is high in celiac disease. I have been sick and so tired lately.  Went to my Dr he thinks it's only a virus.  I think it might be a lot more.  Ant advise???

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    trents

    Are you still consuming dairy and oats, even gluten free oats? Those two foods contains proteins similar enough to gluten to cause celiac reactions in a certain percentage of celiacs. If you have dermatitis herpetiformis you also want to be on a low iodine diet.

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    Dawn Meyers

    No dairy or oats . Even stopped corn rice  pork and beef. Very frustrated! 

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    knitty kitty

    @Dawn Meyers,

    Have you tried the Autoimmune Protocol Diet?  It's a Paleo Diet that cuts out processed gluten free foods, grains, legumes, nightshades, dairy, eggs and nuts.   After the digestive system calms down (about three weeks) add in one food at a time to see if symptoms reappear.  It really helped me.  

    Also, get your Vitamin D level checked.  Vitamin D helps reduce inflammation.  People with psoriasis have lower Vitamin D levels than people without.

    Supplementing with a B Complex and extra Thiamine in the form Benfotiamine helps, too.  Several of the B vitamins (Thiamine, Niacin, Pyridoxine, Cobalamine) can cause peripheral neuropathy which can feel like itching.  Niacin will help Dermatitis Herpetiformis.  Thiamine deficiency can cause diarrhea and nausea.  Niacin deficiency can cause diarrhea and skin rashes.

    Have you been checked for nutritional deficiencies?

    Have you checked any medications for Gluten?  Gluten is frequently used as a filler in many medications.  Check soaps, shampoos, etc., and pet foods for gluten.

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    Dawn Meyers

    Have done the autommune diet. On D3 B12 and folate. Check all medications OK. Use free and clear soap shampoo ect . Clean with vinegar and baking soda. My cat has Graves so she is on gluten free foods.

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    Dawn Meyers

    Have peripheral neuropathy also.

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    knitty kitty

    @Dawn Meyers,

    You would do much better if you took a B Complex that contains all Eight essential B vitamins.  Just taking B12 Cobalamine and Folate can cause a Pyridoxine B6 deficiency.  Pyridoxine deficiency causes Peripheral Neuropathy.  Pyridoxine is one of the vitamins that is notoriously low in celiac disease.  

    Try Benfotiamine in addition to the B Complex.  Thiamine interacts with every single B vitamin.  

    What kind of vinegar are you using? 

     

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    Dawn Meyers

    Plain white vinegar 

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    Dawn Meyers

    I was taking 2000 B12 is there amount you should take? 

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    knitty kitty

    B12 is only one of the B vitamins.  

    You need all eight:

    Thiamine B1, Riboflavin B 2, Niacin B3, Pantothetic Acid B5, Pyridoxine B6, Biotin B7, Folate B 9, Cobalamine B12

    B Complex contains all EIGHT of the B vitamins.  

    White vinegar is made from grain alcohol.  Try Apple Cider Vinegar instead.  It will clean just as well.

    Edited by knitty kitty
    Typo correction
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    Dawn Meyers

    Thank you I will try anything at this point!!!

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    Jefferson Adams

    Jefferson Adams is Celiac.com's senior writer and Digital Content Director. He earned his B.A. and M.F.A. at Arizona State University. His articles, essays, poems, stories and book reviews have appeared in numerous magazines, journals, and websites, including North American Project, Antioch Review, Caliban, Mississippi Review, Slate, and more. He is the author of more than 2,500 articles on celiac disease. His university coursework includes studies in science, scientific methodology, biology, anatomy, physiology, medicine, logic, and advanced research. He previously devised health and medical content for Colgate, Dove, Pfizer, Sharecare, Walgreens, and more. Jefferson has spoken about celiac disease to the media, including an appearance on the KQED radio show Forum, and is the editor of numerous books, including "Cereal Killers" by Scott Adams and Ron Hoggan, Ed.D.

    >VIEW ALL ARTICLES BY JEFFERSON ADAMS

     


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