Gluten is a protein found in wheat, barley, and rye, which most people can digest without trouble. However, in some individuals, gluten triggers adverse reactions, leading to digestive problems and damage to the small intestine.
In severe cases, this sensitivity can affect the nervous system, causing a rare neurological condition known as gluten ataxia, where the immune system mistakenly attacks parts of the brain involved in coordination and balance.
Gluten ataxia is a rare autoimmune disease that occurs when the body's immune system attacks the central nervous system in response to gluten sensitivity. It is related to both coeliac disease and non-coeliac gluten sensitivity.
In genetically susceptible individuals, ingestion of gluten triggers an abnormal immune response. This is believed to involve T-cells that mistakenly attack and cause inflammation in the cerebellum, leading to damage and neurological symptoms. The presence of certain antibodies (e.g., anti-gliadin antibodies) serves as a marker for this immune activation. The cerebellum is a part of the brain located at the back of the head and is responsible for the body's movement. It is directly involved with activities such as balancing, walking, running and speaking.
A person suffering from gluten ataxia can improve the symptoms with a gluten-free diet. Early detection of gluten ataxia can limit its progression and stop further cerebellum damage.
Certain neurological symptoms of gluten ataxia include:
The following section will discuss the probable causes of gluten ataxia:
The progression of gluten ataxia occurs gradually, and symptoms are similar to other types of ataxia. Therefore, medical professionals find it hard to diagnose. In the initial phase, the patient's routine movements are affected. For example, tripping or stumbling while walking. But, as the disease progresses, patients start to feel dizzy, have slurred speech, and find it difficult to write or balance.
Complications of gluten ataxia include progressive loss of coordination, difficulty with balance and walking, slurred speech, and potential permanent neurological damage. If left untreated, it can lead to irreversible impairment of motor functions and significantly impact daily life activities.
Gluten ataxia is diagnosed through a combination of clinical evaluation, medical history, and specific diagnostic tests. Neurologists often assess symptoms such as poor coordination, balance issues, and muscle control.
Diagnosis can be challenging. Blood tests may include anti-tTG6 antibodies, which are more specific for neurological involvement. Standard celiac tests like tTG-IgA may be negative if there is no gut damage. A positive antibody test, coupled with neurological symptoms and MRI findings of cerebellar atrophy, supports the diagnosis. The definitive link is often confirmed by clinical improvement on a strict gluten-free diet.
Early diagnosis is crucial to prevent further neurological damage and ensure better management of the condition through dietary changes.
Treating neurological disorders caused by gluten ataxia is a simple process. It requires patients to completely remove gluten from their diets because even a small amount of it could trigger neurological disorders. The primary treatment is a strict, lifelong gluten-free diet to halt the autoimmune attack and prevent further neurological damage. However, existing damage may be irreversible. Treatment also includes supportive therapies like physical and occupational therapy to improve balance, coordination, and quality of life.
Since it takes some time to recover, it is necessary to have patience. Furthermore, it is crucial to check for any unexplained symptoms of ataxia.
The life expectancy of people suffering from gluten ataxia can vary. For some people, conditions of gluten ataxia remain for a shorter span, while some continue to struggle with it their whole life. Early diagnosis and strict adherence to a gluten-free diet is the most effective solution.
The number of patients with gluten ataxia is difficult to determine since many people still are not aware of the existence of such a disease. However, if someone has gluten ataxia, they will notice that the symptoms get worse over time. If left untreated, it may lead to complete damage to the central nervous system.
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