The intolerance to gluten is a disorder that affects immunological intestinal digestive system chronically, due to a genetic predisposition. The symptomatology of gluten intolerance, also called celiac disease or celiac sprue, appears after ingestion or contact with a protein known as gluten, which is found in foods and chemicals that contain wheat, rye and barley.

Why does gluten intolerance occur?

The gluten produces a chronic inflammatory process level the small intestine, which gradually results in alterations of the intestinal villi, hindering progressively absorption of nutrients, vitamins and minerals.

Celiac disease is the most important representation of the set of autoimmune pathologies associated with gluten that not only can affect the gastrointestinal tract, but also other organs and systems, such as the skin, the respiratory system and the central and peripheral nervous system.

Gluten intolerance and neurological disorders

In the context of gluten intolerance, neurological disorders may or may not be accompanied by intestinal involvement. Generally, when neurological disorders present in isolation, the diagnosis of celiac disease is much later, since other neurological diseases must be ruled out in the first instance.

The main reason why neurological problems occur in celiac disease is the inflammatory state produced by autoantibodies, which can directly attack the nerves, the brain and the cerebellum.

Although the neurological expressions of gluten intolerance are varied, the most common syndromes are cerebellar ataxia (gait and tremulous movements associated with alteration of the cerebellum) and peripheral neuropathy (discomfort associated with damage or irritation of peripheral nerves).

What are the neurological disorders that occur in gluten intolerance?

The neurological manifestations vary from migraine headaches, through psychiatric pathologies such as depression and personality disorders, to nervous disorders such as neuropathies and polyneuropathies (alteration of various nerves) that affect muscle sensitivity and strength.

Among neurological disorders are:

· Cerebellar ataxia: According to the National Institute of Neurological Disorders and Strokes, cerebellar ataxia is also called spinocerebellar degeneration, which manifests as a tremor during walking, loss of balance and limitations in movements. In the case of gluten intolerance, most case reports speak of sporadic outbreaks of cerebellar ataxia, which tend to worsen with advancing age. Cerebellar ataxia can be due to other diseases such as cerebrovascular accidents, alcoholism, tumors, among others.

· Migraine headache: episodic headaches appear, above all, every time the person consumes gluten.

· Gluten neuropathy: damage to the peripheral nerves can manifest as tingling, sudden pain, hypersensitivity to cold or heat, exaggeration of pain, cramps, among others. All of these alterations are due to direct or indirect nerve damage associated with autoantibodies.

· Disorders sensory-motor: the intolerance gluten has been associated with disorders such as restless leg syndrome (characterized leg movement while the individual sleeps) syndrome Stiff - person (contracture paravertebral muscles).

· Psychiatric disorders: people with celiac disease can have psychiatric outbreaks manifested as depression, personality disorders with manic and depressive phases. Cognitive deficits (memory and concentration disorders) have also been described.

· Epilepsy: Studies report that the frequency of occurrence of epilepsy is higher in celiac patients than in patients without gluten intolerance. However, gluten has not yet been determined to cause seizures.

Treatment

The intolerance to gluten has no cure, so the recommendation in all cases is to avoid foods that contain it, in order to prevent new outbreaks. Likewise, it is recommended to avoid the use of food utensils that have been previously used to prepare foods with gluten, due to the phenomenon called "cross contamination".

It is also recommended that gluten intolerant patients check all the ingredients of the chemical products they use daily, such as cosmetics, bathroom and cleaning utensils, since some may contain products derived from gluten and worsen symptoms just by being in contact with these.

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