Article Text

Findings that shed new light on the possible pathogenesis of a disease or an adverse effect
Vacuolar leucoencephalopathy and pulvinar sign in association with coeliac disease
  1. A M Ryan1,
  2. J Ryan1,
  3. M Wan-Ahmed1,
  4. O Hardiman2,
  5. M A Farrell3,
  6. B McNamara4,
  7. B J Sweeney1
  1. 1
    Department of Neurology, Cork University Hospital, Cork, Ireland
  2. 2
    Department of Neurology, National Institute for Neurology and Neurosurgery, Beaumont Hospital, Dublin, Ireland
  3. 3
    Department of Neuropathology, National Institute for Neurology and Neurosurgery, Beaumont Hospital, Dublin, Ireland
  4. 4
    Department of Neurophysiology, Cork University Hospital, Cork, Ireland
  1. bsweeney{at}eircom.net

Summary

Several neurological disorders have been associated with coeliac disease, including epilepsy, ataxia and neuropathy. Here we report a rare case of white matter disease in a 55-year-old man with coeliac disease. He presented with anxiety, headache and left upper limb jerking. He subsequently developed epilepsy and brain MRI revealed diffuse white matter abnormality. He died 6 months after presentation due to status epilepticus and sepsis. Brain biopsy demonstrated vacuolar leucoencephalopathy with no evidence of vCJD. An extensive clinical screen excluded infectious, inflammatory and para-neoplastic causes for this condition. Coeliac disease may be causally associated with vacuolar leucoencephalopathy in this case.

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Footnotes

  • Competing interests: none.

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