Epilepsy in Children with Celiac Disease: Clinical and Electroencephalographic Characteristics and Outcomes in a Ten-Patient Case Series

Abstract

Celiac disease is an immune-mediated systemic disorder triggered by gluten exposure in genetically predisposed individuals. Epilepsy has been reported among the neurological manifestations associated with celiac disease; however, the relationship between epilepsy and celiac disease remains incompletely understood, and their coexistence does not necessarily imply causality. This ten-patient case series describes the clinical, electroencephalographic, and follow-up characteristics of children with both epilepsy and celiac disease. Seven patients had focal epilepsy, whereas three had generalized epilepsy phenotypes, including presumed juvenile myoclonic epilepsy, presumed juvenile absence epilepsy, and sleep-related generalized tonic-clonic seizures. Electroencephalography most commonly demonstrated posterior epileptiform abnormalities. Following initiation of a gluten-free diet and appropriate antiseizure medication, seizure freedom was achieved in all patients during follow-up. These findings suggest that epilepsy may occur in children with celiac disease and that favorable outcomes may be observed after dietary treatment. However, the present data should be interpreted as an association rather than evidence of causality.