CEREBELLAR SIGNS IN CELIAC DISEASE

Celiac disease (CD) and dermatitis herpetiformis are autoimmune disorders due to gluten intolerance. About 10% of patients with CD, but not dermatitis, show neurologic dysfunction not attributable to malabsorption, and in some patients without CD or dermatitis, an autoimmune response triggered by gluten epitopes is considered to cause a cerebellar syndrome.1,2 However, the existence of the so-called gluten ataxia is still a matter of debate.3–5 We evaluated the occurrence of cerebellar symptoms and signs in patients with CD who never required a neurologic evaluation for their complaints. ### Methods. Forty-two patients with CD (mean age, 38.6 years; range, 13–75) and 71 age- and sex-matched healthy subjects agreed to participate in the study, which was approved by the local ethical committee. Patients with CD were on a gluten-free diet for 53.7 months (range, 1–348), and 12 of them were still endomysial antibodies (EMA)–positive at the time of assessment. Compliance with the diet was rated as 0 (poor), 1 (fair), or 2 (good) by a dietary interview. The subjects underwent neurologic examination and reflexive saccade eye movements.6 We considered each subject in terms of the mean value of latency (![Graphic][1] ), peak velocity ![Graphic][2] and precision (![Graphic][3] ;P = A/ TS , where A is saccade amplitude and TS is the target step in deg). Reflexive saccade latency is under a cortical control, saccade velocity depends on the … [1]: /embed/inline-graphic-1.gif [2]: /embed/inline-graphic-2.gif [3]: /embed/inline-graphic-3.gif