What Is Migraine?

M igraine is a neurologic disorder characterized by reduced cerebral blood flow that causes a severe headache. The pain is usually on one side of the head, pulsates, and is aggravated by bodily exertion that increases blood pressure.

The type of migraine can be classic with an aura or non-classic without an aura.

Classic migraine begins with an aura that develops over minutes and may last up to an hour before, during, or after the headache. Some people can tell when they are about to have a migraine because they see flashing lights or zigzag lines or they temporarily lose their vision.

Q: What does the aura signify?

A: According to the International Headache Society, an aura signifies an area of brain dysfunction. An aura is different from a trigger. A trigger brings on a migraine while an aura is a response to decreased blood flow.

A study investigating what triggers a migraine found these statistics in 1027 participants of whom 75.9% reported triggers (40.4% infrequently, 26.7% frequently and 8.8% very frequently).

The trigger frequencies were stress (79.7%), hormones in women (65.1%), not eating (57.3%), weather (53.2%), sleep disturbance (49.8%), perfume or odour (43.7%), neck pain (38.4%), light(s) (38.1%), alcohol (37.8%), smoke (35.7%), sleeping late (32.0%), heat (30.3%), food (26.9%), exercise (22.1%) and sexual activity (5.2%).¹

Migraine affects about 12% of the U.S. general popululation. It is three times more common in women than in men.

What Is Migraine In Celiac Disease and/or Gluten Sensitivity?

Sources:

1. Kelman L. The triggers or precipitants of the acute migraine attack. Cephalalgia. 2007 May;27(5):394-402. Epub 2007 Mar 30. [↩]

What Is Multiple Sclerosis?

M ultiple sclerosis is an autoimmune disease of the central nervous system characterized by patchy inflammation of the myelin sheath surrounding nerve cells that produces multiple and varied neurologic symptoms and signs due to demyelination.

Q: What does demyelination mean.

A: Demyelination means there is damage to the myelin sheath which is a fatty substance that surrounds and protects nerve cells much like a the covering of a lamp cord keeps the electricity flowing within it from the plug to the light bulb. This damage impairs transmission of nerve impulses between the brain and body.

In the process of demyelination, T-lymphocyte cells that are activated and potentially autoimmune cross the blood-brain barrier and produce inflammatory plaques and axonal tissue loss in the brain, spinal cord or optic (vision) nerves. The end result is the accumulation of gliosis (scarring) and demyelination of areas in the central nervous system.¹

The course of multiple sclerosis is unpredictable and slowly progressive, usually with  exacerbations (worse symptoms) and remissions (relief of symptoms).

Multiple sclerosis affects about 1 ‰ of the population worldwide.

What Is Multiple Sclerosis In Celiac Disease and/or Gluten Sensitivity?

Sources:

1. Rodrigo L, Hernández-Lahoz C, Fuentes D, Alvarez N, López-Vázquez A, González S. Prevalence of celiac disease in multiple sclerosis. BMC Neurol. 2011 Mar 7;11:31. doi: 10.1186/1471-2377-11-31. [↩]

What Is Occipital Lobe Epilepsy With Cerebral Calcifications?

O ccipital lobe epilepsy with cerebral calcifications is a seizure disorder that develops from calcium deposits in the brain.

This condition is characterized by repetitive abnormal electrical discharges within the brain that may manifest as paroxysmal, or sudden recurrence of, visual disturbances.

Q: Where is the occipital lobe?

A: The occipital lobe is one of four lobes of the cerebrum, or upper brain. It comprises the lower rear portion of the cerebrum and mainly processes visual images coming to  it from the eyes through the optic nerve.

In this image of the left side of the brain, the occipital lobe is pink. From Wikimedia.                                                                                      

What Is Occipital Lobe Epilepsy With Cerebral Calcifications In Celiac Disease and/or Gluten Sensitivity?

What Is Progressive Multifocal Leukoencephalopathy?

P rogressive multifocal leukoencephalopathy is a progressive demyelinating disorder of the central nervous system (brain) caused by JC virus that leads to rapid death.

Progressive multifocal leukoencephalopathy usually occurs as an opportunistic infection in patients with underlying depression of cell-mediated immunity. It has been recognized that the JC virus is highly prevalent in the adult population, with 50–90% of healthy individuals having been exposed to the virus. Approximately 85% of the population has antibodies to JC virus. The virus’ purported site of latency in the human body is currently under debate.¹

Progressive multifocal leukoencephalopathy is characterized by tissue loss of subcortical white matter (brain tissue) and active perivascular inflammatory foci (locations in blood vessels) with numerous eosinophilic granulocytes (white blood cells).

Q: What is demyelinating?

A: Demyelinating means there is damage to the myelin sheath of nerve cells called oligodendrites in the brain. In this disorder the damaged, irregular areas caused by the infection get progressively bigger.

The myelin sheath is a fatty substance that surrounds and protects nerve cells and enhances the transmission of nerve impulses much like the covering of a lamp cord keeps the electricity flowing within it from the plug to the light bulb. Damage to the myelin sheath impairs transmission of nerve impulses in the way that fraying an electric cord impairs the flow of electricity. 

What Is Progressive Multifocal Leukoencephalopathy In Celiac Disease and/or Gluten Sensitivity?

Sources:

1. Gourineni VC, Juvet T, Kumar Y, Bordea D, Sena KN. Progressive multifocal leukoencephalopathy in a 62-year-old immunocompetent woman. Case Rep Neurol Med. 2014;2014:549271. doi: 10.1155/2014/549271. [↩]

What Is Cerebral Vasculitis?

C erebral vasculitis, also called vasculitis of the central nervous system (CNS), is an autoimune attack against elastin fibers in the walls of arteries that bring blood to the head. Early recogniton may reduce poor outcomes.¹

Cerebral vasculitis is characterized by inflammation of large, medium, or small blood vessels which is often segmental with scattered foci (sites) of intense inflammation, and results in necrosis (death) of affected tissues with scarring that occludes, or blocks, blood flow.

Q: What happens when an artery is occluded by scarring?

A: When an artery is occluded by scarring, blood cannot flow through it thus preventing the body tissues it supplies with oxygen and nutrition.   Depending on vessels that are affected, blindness, TIA (transient ischemic attack) or stroke may result from blockage or rupture (hemorrhage).

Blood flow through arteries can be seen by angiography procedure. The diagnosis is made by biopsy. Additionally, contrast-enhanced MRI, proven to be sensitive to extradural arteritis, for the identification of intracranial vessel wall inflammation shows that wall thickening and intramural contrast uptake are frequent findings in patients with active cerebral vasculitis affecting large brain arteries.²

Vasculitis may develop with  autoimmune diseases, such as celiac disease, lupus eythematosis and rheumatoid arthritis due to immune complexing, and possibly severe infection and drug sensitivity.

What Is Cerebral Vasculitis In Celiac Disease and/or Gluten Sensitivity?

Sources:

1. Salvarani C, Brown RD Jr, Calamia KT, Christianson TJ, Weigand SD, Miller DV, Giannini C, Meschia JF, Huston J 3rd, Hunder GG. Primary central nervous system vasculitis: analysis of 101 patients. Ann Neurol. 2007 Nov;62(5):442-51. [↩]
2. Küker W, Gaertner S, Nagele T, Dopfer C, Schoning M, Fiehler J, Rothwell PM, Herrlinger U. Vessel wall contrast enhancement: a diagnostic sign of cerebral vasculitis. Cerebrovasc Dis. 2008;26(1):23-9. doi: 10.1159/000135649. Epub 2008 May 30. [↩]

What Is Anxiety?

A nxiety or worry is a distressing emotional state of mind or mood that is characterized by a vague uneasiness, unpleasant feelings of apprehension or anticipation of danger and by interference with normal functioning, ranging from mild qualms and easy startling to occasional panic.

Q: What causes anxiety?

A: Anxiety can be a normal response to stress such as making an important decision, illness, divorce, problems at work or preparing for an exam.

In a dangerous situation, profound physiological changes rapidly prepare us for a “fight or flight” response by release of adrenalin hormone. Adrenalin speeds up metabolism to make available quick energy, tightens muscles in readiness, and speeds up the heartbeat and breathing so that more oxygen is made available to the brain and muscles.

Anxiety becomes a maladaptive disorder when it is excessive, unrealistic, or not provoked and impairs the ability to lead a normal life.

Anxiety that is part of a person’s personality is called “trait anxiety.” Anxiety that comes and goes is “state anxiety,” as in state of mind, and is usually due to unresolved stress or an underlying health problem.

What Is Chronic Anxiety in Celiac Disease?

What Is Apathy?

A pathy is an abnormal emotional state that is characterized by indifference to things which others find interesting, moving or exciting, and diminished motivation to perform regular daily activities.

The neural mechanisms of apathy are postulated to involve the brainstem and forebrain circuits that regulate goal-directed behavior.¹

What Is Apathy In Celiac Disease and/or Gluten Sensitivity?

Sources:

1. Marin RS. Apathy: Concept, Syndrome, Neural Mechanisms, and Treatment. Semin Clin Neuropsychiatry. 1996 Oct; 1(4):304-314. [↩]

What Is Depression?

D epression is a mood disorder characterized by absence of cheerfulness, dejection, and loss of interest or pleasure in living, making the person dysfunctional and unable to cope with or perform tasks of daily living.

More than a feeling, this negative psychological status can range from mild to profound and can involve other parts of the body, causing physical problems such as poor digestion, constipation, weight gain or weight loss, mentrual irregularities in females, and impotence in males.

Q: How is depression identified?

A: According to the American Psychiatric Association, depression is a psychic condition that lasts for more than a month and involves four or more of these symptoms:

• Abnormal appetite.
• Diminished ability to concentrate or think properly.
• Feelings of worthlessness.
• Low energy or fatigue.
• Physical inactivity or hyperactivity.
• Sleep disturbances.
• Thoughts of death.

Grief or sadness at the loss of a loved one or a similar event or remorse for sin is normal. However, depression that is prolonged usually involves imbalances of nerve chemicals called neurotransmitters. Imbalances can result from health disorders such as hormonal imbalances, low blood sugar, stress, drug side effects, or nutrient deficiencies.

What Is Depression In Celiac Disease and/or Gluten Sensitivity?

What Is Inability To Concentrate?

I nability to concentrate is a mental dysfunction characterized by trouble fixing the mind on one subject to the exclusion of all other thoughts.

What Is Inability To Concentrate In Celiac Disease and/or Gluten Sensitivity?

What Is Insomnia?

I nsomnia is a distressing sleep disorder that includes inability to fall asleep, inability to stay asleep, and inability to get deep sleep depending on the type of insomnia.

Q: What are the types of insomnia?

A: There are two types of insomnia: primary or secondary which have different causes.

1. Primary insomnia is characterized by sleeplessness due to reduction of synthesis of neurotransmitters (brain chemicals) in the central nervous system (brain) required for sleep, especially melatonin. Melatonin is produced during the night hours by the pineal gland from tryptophan, an essential amino acid derived from food.

Neurotransmitters are released when the axon terminal of a presynaptic neuron (nerve cell) is stimulated and acts by stimulating or inhibiting a target nerve cell.

2. Secondary insomnia has many causes. It can be a feature of malnutrition, lack of exercise, heartburn, mental disorders such as dementia and psychosis, emotional disorders such as depression and anxiety, guilt, worry, many conditions that involve itchiness, pain, disability, and a side effect of certain medications.

What Is Insomnia In Celiac Disease and/or Gluten Sensitivity?