Martínez-Bermejo A, Polanco I
Servicio de Neuropediatría, Hospital Universitario La Paz, Universidad Autónoma de Madrid, Madrid, Spain.
Rev Neurol. 2002 Feb;34 Suppl 1:S24-33.
Coeliac disease is a gastrointestinal disorder caused by intolerance to cereals due to an immunological mechanism. The intestinal mucosa is damaged, causing a severe malabsorption syndrome. The diagnosis is based on classical clinical features such as diarrhoea and weight loss. However, there is a broad spectrum of this disorder which includes disorders of other organs and systems. In this paper we review the main studies of involvement of the nervous system in coeliac disease.
Studies published to date report a high prevalence of ataxia, headaches and epilepsy, especially associated with bilateral occipital calcifications together with psychological features and psychiatric disorders including behavior change, depression, schizophrenia, autism, and disorders of personality, emotion and family relationships. Problems of learning and cognition are less common.
Many of these processes have only relatively recently been recognized. The pathogenic mechanism of these disorders is not completely clear although biochemical factors such as a low plasma serotonin level may be a cause. Treatment is based on the early recognition of the disorder which is difficult to suspect when there are no gastrointestinal symptoms present and the use of various types of treatment, including a cereal free diet, which is the most effective.
乳糜泻是一种由于免疫机制对谷物不耐受而引起的胃肠道疾病。肠黏膜受损，导致严重的吸收不良综合征。诊断基于腹泻和体重减轻等典型临床特征。然而，这种疾病有广泛的表现形式，包括其他器官和系统的病症。在本文中，我们综述了关于神经系统受累于乳糜泻的主要研究。
迄今为止发表的研究报告称，共济失调、头痛和癫痫的患病率很高，尤其是与双侧枕部钙化相关，同时还伴有心理特征和精神障碍，包括行为改变、抑郁、精神分裂症、自闭症以及人格、情感和家庭关系方面的障碍。学习和认知问题则不太常见。
其中许多过程直到最近才被认识到。这些病症的致病机制尚不完全清楚，尽管诸如血浆5-羟色胺水平低等生化因素可能是一个原因。治疗基于对该疾病的早期识别（当没有胃肠道症状时很难怀疑）以及使用各种类型的治疗方法，包括无谷物饮食，这是最有效的治疗方法。
