Iranian Journal of Child Neurology

Abstract

Objective
Epilepsy occurs with a yearly incidence of 40 per 100,000 children, of which more than 25% are resistant to drug therapy. Epilepsy may occur in autoimmune
diseases like lupus, celiac disease and myasthenia gravis. In this study, the
relationship between celiac disease and refractory epilepsy was evaluated in
children with idiopathic epilepsy.
Material & Methods
Hundred-fifty-five children (mean age, 6.7±3.3 years) with idiopathic and
cryptogenic epilepsy referred to the neurology clinic were studied in two groups;
drug controlled epilepsy (control, 82 patients) and refractory epilepsy groups
(case, 73 patients). Both groups underwent serological tissue transglutaminase
antibody measurement by ELISA. In seropositive cases, small intestine biopsy
was conducted. Data analysis was performed using student's t test and 2 test.
Results
Seven (0.04%) patients had celiac disease based on a positive tissue
transglutaminase antibody and three patients (0.01%) based on a positive biopsy.
Three patients (2.4%) with drug controlled epilepsy (control group) and five
with refractory epilepsy (case group) had seropositive celiac disease (p=0.255).
In the biopsy survey of six seropositive patients, one patient (1.2%) in the drug
controlled epilepsy and two patients (2.7%) in the refractory epilepsy group had
positive biopsy for celiac disease (p = 0.604). One seropositive patient did not
cooperate for biopsy.
Conclusion
If the relationship between celiac disease and epilepsy, especially in cases
of symptomatic or oligosymptomatic celiac is proved, using gluten free
diet increases the ability to control epilepsy particularly in refractory cases.
We suggest celiac disease survey is not required in patients with idiopathic
epilepsy.