A gluten-free diet in patients with epilepsy who have celiac disease completely prevented seizures in six out of seven patients, and allowed the seventh patient to reduce by half the dose of antiepileptic drugs.
As celiac disease is increasingly diagnosed in adults, the findings suggest that epileptic patients with stomach problems should be screened for the condition, since the introduction of a gluten-free diet can improve the control of seizures.
The study, “Celiac Disease and Epilepsy: The Effect of Gluten-Free Diet on Seizure Control,” was published in the journal Advances in Clinical and Experimental Medicine.
Once believed to be a disease affecting only the stomach, celiac disease, or gluten intolerance, is now known to give rise to a range of atypical symptoms. This makes the condition difficult to diagnose.
Earlier research has shown that neurologic or psychiatric disease develops in up to 22 percent of patients with celiac disease, and about 57 percent of patients with neurologic or psychiatric conditions have antibodies against gliadin — a protein present in gluten.
Researchers at the Kermanshah University of Medical Sciences in Iran, therefore, decided to assess how common celiac disease is among epileptic patients, and to explore whether eliminating gluten from their diet could impact the frequency of seizures.
The study recruited 113 people with epilepsy aged 16-42. Participants had various forms of epilepsy, with 46 percent having generalized tonic-clonic seizures, 38 percent with complex partial seizures, and 16 percent with complex partial seizures with secondary generalization.
Most patients (55 percent) had one seizure a month, while 22 percent had seizures about once a week and 23 percent had seizures only a few times a year.
The research team screened the participants for celiac disease using standard antibody tests, and found seven individuals, or 6 percent, testing positive for the condition. Celiac disease was also confirmed by intestinal tissue biopsies. Among the seven patients, three had weekly seizures and four had about one seizure per month.
Sticking to a gluten-free diet for five months allowed six of the seven patients to stop antiepileptic treatment, as their seizures had completely stopped. A seventh patient continued treatment with half his previous dose of carbamazepine.
“Accumulating evidence suggests that CD is frequent in epileptic patients and it is suggested that epileptic patients with gastrointestinal symptoms are screened for CD. Administration of a combination of a gluten-free diet with anticonvulsant treatment is useful in patients with treatment-resistant epilepsy,” the researchers concluded.