Gluten and Epilepsy: Is There a Connection?

Could the gluten-free diet help some people with epileptic seizures?

medical form with epilepsy seizures box checked
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Epilepsy is a seizure disorder that creates various symptoms, such as strange sensations, staring spells, limb jerking and even loss of consciousness. People who have epilepsy may suffer seizures only occasionally or experience numerous ones throughout day. Treatments for the condition usually involve medication and can even include surgery.

Researchers have linked epilepsy with celiac disease, noting that a high prevalence of celiac has been seen in patients who have "bilateral occipital calcifications" (literally, small deposits of calcium in their brains) and epilepsy.

In addition, there are case reports about epilepsy patients who improved dramatically or recovered completely on the gluten-free diet once they also were diagnosed with celiac disease.

There's also one recent case report of a child who didn't have celiac disease recovering completely from epilepsy after being diagnosed with non-celiac gluten sensitivity and adopting the gluten-free diet.

However, as with many neurological illnesses that share links to celiac disease and non-celiac gluten sensitivity, it's not entirely clear how gluten might cause or contribute to epilepsy and how many people with epilepsy might be helped by going gluten-free.

Some doctors have theorized that nutritional deficiencies in people with intestinal damage caused by celiac disease might create neurological symptoms, including seizures. Other researchers speculate that gluten causes changes in the brain more directly.

Like Celiac Disease, Epilepsy Occurs in About 1 in 100 People

Epilepsy is a relatively common condition — it occurs in about 1% of the population. It's most commonly diagnosed in young children and in those over age 65, but it can occur at any age. In order to be diagnosed with epilepsy, you must have experienced at least two seizures.

In most people with epilepsy, medication can control the condition completely. However, up to about 30% of those with epilepsy continue to experience seizures despite carefully adhering to their medication regimens. These cases are called "intractable epilepsy."

Sometimes, epileptic seizures will decrease in frequency or even stop completely on their own over time, especially if the condition wasn't severe or if the person was diagnosed in early childhood. Physicians don't really understand why this occurs.

Studies Show High Rate of Celiac Disease in Epilepsy Patients

People with epilepsy seem to be diagnosed with celiac disease far more often than the general population.

One study, which looked at the incidence of common neurological and psychiatric conditions among 620 people with celiac disease at a clinic in Derby, U.K., found 25 of them — or 4% — also had been diagnosed with epilepsy. Other studies also have found similarly high rates of epilepsy in people who have celiac.

The connection with epilepsy is less clear when it comes to non-celiac gluten sensitivity.

Several doctors, including neurologist and gluten ataxia expert Dr. Marios Hadjivassiliou, have theorized that blood tests for the antibody AGA-IgG can be used to look for gluten sensitivity that might cause neurological complications, including epilepsy.

In two studies, researchers found higher rates of AGA-IgG antibodies in people with epilepsy than they did in separate control groups without neurological problems.

However, the idea that physicians should use the AGA-IgG test to screen epilepsy patients for gluten sensitivity isn't shared by most mainstream physicians; as of now there isn't an accepted test for gluten sensitivity.

Gluten-Free Diet Potential Epilepsy Treatment?

In people with diagnosed celiac disease, there's some evidence in medical studies that adhering to the gluten-free diet may help them control their seizures. In one case report, a 23-year-old woman who had intractable epilepsy for 11 years was diagnosed with celiac disease and started a gluten-free diet. She experienced a "dramatic improvement" in her previously uncontrolled seizures once she was eating gluten-free.

Right now, there's only a little bit of evidence from the medical literature that the gluten-free diet can help people with epilepsy who haven't been diagnosed with celiac disease control their seizures.

In one case study published in 2014, doctors reported on a two-year-old boy who developed epileptic seizures that didn't respond to medication. They tested him for celiac disease and found he likely didn't have it, but he did have one of the two main celiac disease genes. Based on that, they decided to try the gluten-free diet, and it worked for the boy: his seizures gradually slowed and then stopped, even without medication.

There also are anecdotal reports from people with epilepsy who say that switching to the gluten-free diet has helped them, even though they tested negative for celiac disease.

Finally, it appears important in someone who has both celiac disease and epilepsy — especially epilepsy with those occipital calcifications on the brain — to get diagnosed with celiac and start the diet as quickly as possible to halt or reverse the calcifications.

One study, conducted in Argentina, found that the white spots decreased or disappeared after three months on the gluten-free diet in some epilepsy patients who were newly diagnosed with celiac disease. Another study, this one in Uruguay, reported on three school-aged boys who were diagnosed with both conditions; the boys were seizure-free over the next eight years as they both followed the gluten-free diet and took anti-convulsant medications.

"It is of vital importance to investigate celiac disease 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," the study authors concluded.

Sources:

Arroyo H.A. et al. Epilepsy, occipital calcifications, and oligosymptomatic celiac disease in childhood. Journal of Child Neurology. 2002 Nov;17(11):800-6.

Bruni O et al. An unusual case of drug-resistant epilepsy in a child with non-celiac gluten sensitivity. Seizure. 2014 Sep;23(8):674-6.

Canales P. et al. Epilepsy and celiac disease: favorable outcome with a gluten-free diet in a patient refractory to antiepileptic drugs. Neurologist. 2006 Nov;12(6):318-21.

Diaz R.M. et al. [Epilepsy, cerebral calcifications and coeliac disease. The importance of an early diagnosis]. Revista de Neurologia. 2005 Apr 1-15;40(7):417-20.

Madrid S. et al. [Silent celiac disease among 21 patients with cryptogenic epilepsy]. Revista medica de Chile. 2011 May;139(5):587-91. Epub 2011 Sep 16.

National Institute of Neurological Disorders and Stroke. Seizures and Epilepsy: Hope Through Research. Fact sheet, accessed March 26, 2012.

Penigiran Tengah D.S. et al. Neurological complications of coeliac disease. Postgraduate Medical Journal. 2002 Jul;78(921):393-8.

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