Relationship between Celiac Disease and Refractory Idiopathic Epilepsy in Children

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.