Celiac disease and associated extraintestinal manifestations, with special reference to neurological disorders

Abstract

Celiac disease (CD), also known as gluten-sensitive enteropathy and nontropical sprue, is one of the most important entities of the wide spectrum of gluten-related disorders (GRDs). It is well known that neurological manifestations can be present either at the onset of CD, or appear during the development of the pathology, and the neurologic findings can show a profound difference. Clinical features show significant variation, ranging from typical manifestations of gastrointestinal involvement to several extraintestinal diseases. The most frequent neurologic signs reported are headaches, epileptic seizures, and migraines. Polyneuritis and the cerebellar ataxias have shown the most frequent association in adults. Headache either in the form of migraine or in nonspecific form represents one of the main clinical presentations in CD. This work aims to provide a narrative review of the current state of CD, highlighting the main extraintestinal disorders associated with CD. Complete compliance to a gluten-free diet (GFD) seems to improve the neurological symptoms even though the underlying pathogenic relationship between CD and the neurologic system remains poorly understood.