[Epilepsy, cerebral calcifications and coeliac disease. The importance of an early diagnosis].
BACKGROUND
Coeliac disease (CD) has been linked to several neurological disorders, with a clearly higher incidence of epilepsy than in the general population. Since Gobbi's original description of the epilepsy with cerebral calcifications and coeliac disease syndrome in 1992, various reports have been published concerning different stages of development, although a number of questions remain to be answered with respect to its pathogenesis. The aim of this study is to describe the clinical symptoms and progression of three patients with the characteristic syndrome, who were diagnosed in the early stages of the disease.


METHODS
We describe the cases of three males, of school age, who visited because of partial seizures with visual symptoms that were secondarily generalised. A tomography scan of the head revealed bilateral occipital calcifications in all cases. The electroencephalogram showed temporooccipital paroxysmal discharges with a normal background rhythm. Tests for antiendomysium and antigliadin antibodies, with positive results, and a small intestine biopsy study were requested, which confirmed the suspicion of a grade 3 severe enteropathy. All the patients, following a gluten-free diet and taking anticonvulsants, were free of seizures in the follow-up (1, 2 and 8 years).


CONCLUSIONS
It is of vital importance to investigate CD in any patient with epilepsy and occipital cerebral calcifications, even in the absence of digestive symptoms, since early diagnosis and treatment with exclusion of gluten affect how the syndrome courses later on.
Díaz
R M
RM
Centro Hospitalario Pereira Rossell, Montevideo, Uruguay. romadiaz@msn.com
González-Rabelino
G
G
Delfino
A
A
D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology; D002114:Calcinosis / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000473:pathology*; D002446:Celiac Disease / Q000178:diet therapy / Q000453:epidemiology*; D002648:Child; D004569:Electroencephalography; D004827:Epilepsy / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D005983:Glutens / Q000009:adverse effects; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009778:Occipital Lobe / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D012720:Severity of Illness Index; D013702:Temporal Lobe / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D014057:Tomography, X-Ray Computed
D005983:Glutens