Occipital Lobe Epilepsy With Cerebral Calcifications

What Is Occipital Lobe Epilepsy With Cerebral Calcifications?

[dropcap]O[/dropcap]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?

• Occipital lobe epilepsy with cerebral calcifications is an associated neurologic disorder of celiac disease.

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

The prevalence of occipital lobe epilepsy with cerebral calcifications is not established but is reported as associated with celiac disease.¹,²

What Are The Symptoms Of Occipital Lobe Epilepsy With Cerebral Calcifications?

Occipital lobe epilepsy with cerebral calcifications is marked by paroxysmal visual disturbances representing seizures such as such as

• Blurred vision.
• Loss of focus.
• Seeing colored dots.
• Brief stereotyped complex visual hallucinations like seeing unfamiliar faces or scenes and alteration in consciousness.

How Does Occipital Lobe Epilepsy With Cerebral Calcifications Develop In Celiac Disease and/or Gluten Sensitivity ?

• Occipital lobe epilepsy with cerebral calcifications results from unclear etiology involving gluten exposure.
• Reduced central nervous system folate levels secondary to folate malabsorption is a suggested mechanism of calcification in this syndrome as folate deficiency is seen in all major causes of cerebral calcification.³

Does Occipital Lobe Epilepsy With Cerebral Calcifications Respond To Gluten-Free Diet?

Yes. Occipital lobe epilepsy responds to gluten free diet.⁴,³

6 Steps To Improve Occipital Lobe Epilepsy With Cerebral Calcifications In Celiac Disease and/or Gluten Sensitivity:

• [dropcap]1[/dropcap]Remove the Trigger. Maintain a Strict, Nutritious Gluten Free Diet:

[box type=”shadow” ]Treatment. This condition responds to the complete elimination of gluten, which is the required treatment that improves both epilepsy and gut health.

• Gut health is the foundation to restore ALL health. Restored health will enable you to maintain a strict gluten free diet, just as other life tasks will be easier.
• A strict gluten free diet means removing 100% of wheat, barley, rye and oats from the diet.
• Cutting out bread and other obvious sources of gluten is not good enough for recovery. Even 1/8th teaspoon of flour or bread crumb is enough to sustain the inflammation that is damaging your small intestine, causing increased permeability (leaky gut) and allowing undigested gluten to enter your body where it can damage structures and function, and instigate immune inflammatory responses.

Correct Your Individual Nutritional Needs.

• Eat foods that can replenish missing nutrients. Find them under NUTRIENT DEFICIENCIES.
• Take nutritional supplements as needed. Find them under NUTRIENT DEFICIENCIES.

Recovery. You should begin to feel better within a week and notice more energy as inflammation subsides and the  absorbing cells that make up the surface lining of your small intestine are better able to function.

• Intestinal lining cells are replaced every 5 days. The healing process is like sunburn where the damaged surface layer of skin sloughs off and is replaced with new normal cells.
• Leaky gut normally resolves in two month after starting a gluten free diet and brings about a big improvement in health. Improvement in intestinal permeability precedes morphometric recovery (cell appearance and structure) of the small intestine in celiac disease.⁵
• The intestinal lining may take up to a year to heal.[/box]

• [dropcap]2[/dropcap] Reduce Inflammation. Foods to Eat and Foods Not to Eat:

Because gluten is inflammatory, eliminate OTHER inflammatory foods from your diet to reduce an additive effect to gluten. At the same time, try to eat foods that reduce inflammation (anti-inflammatory).

[box type=”shadow” ]Here Are Major Inflammatory Food Types That Reduce Healing:

• Damaging Foods. In susceptible persons, includes corn, dairy (cow), and soy. Lactose, the sugar in any animal milk disrupts intestinal permeability causing leaky gut.⁶
• Allergenic Foods. Includes foods that trigger the immune sytem to produce IgE antibodies. Allergy testing is the usual way to discover these offending foods.
• Shelf Stable Processed Foods. Includes any that contain additives and preservatives. Look for them on the nutrition label of the box or package. Additives and preservatives also disrupt intestinal permeability causing leaky gut.⁶
• Fats. Limit deep fried foods, trans-fats, saturated fats (animal fat/butter), and EXCESSIVE omega-6 fatty acid oils like corn oil. Rancid fats, sodium caprate (a medium chain fat), and sucrose monester fatty acid (a food grade surfactant) induce significant disruption of the intestinal barrier that causes leaky gut.⁶.
• Excessive Refined White Flours (bran layer removed). Includes products made from them such as cookies, bread, cakes, pies. Bran contains the vitamins and minerals that metabolize grains and slows the otherwise rapid entry of sugar from their digestion into the bloodstream. Also disrupt intestinal permeability causing leaky gut.⁶
• Refined Sugars.  Includes white sugar, corn fructose and high fructose corn syrup.
• Certain Spices. Includes paprika and cayenne pepper which disrupt intestinal permeability causing leaky gut.⁶
• Alcohol and Caffeine. Disrupt intestinal permeability causing leaky gut.⁶[/box]

[box type=”shadow” ]Here Are Important Anti-Inflammatory Food Types to Promote Health:

• Fruits. Contain ample amounts of vitamins, minerals and phytochemicals which are naturally occuring components in plants that detoxify toxins, carcinogens (reducing the risk by 50%) and mutagens.
• Non-Starchy Vegetables. Support intestinal integrity and provide ample amounts of vitamins, minerals and phytochemicals. Includes green leafy vegetables such as lettuce and kale, also onion, broccoli, garlic, and others.
• High Quality Complex Carbohydrates. Provide vitamins, minerals, and fiber while boosting serotonin levels to help you relax and feel calm. Includes whole grains, legumes, and root vegetables such as carrots, parsnips, sweet potatoes, turnips, red beets, and others.
• Antioxidants. Protect the body from inflammatory oxidant molecules that continually occur and help us handle stress and reduce irritability. Includes vitamin C-containing foods such as lemon, grapefruit, apricot, Brussels sprouts and strawberries, and others. Also, includes vitamin E-containing foods such as nuts, seeds, avocado, olive oil, and others. Cocoa is good, too.
• Omega-3 Fatty Acids. Balance opposing omega-6 fatty acids and bad fats. Fish sources includes tuna, salmon, cod, and others. Plants sources include flax, chia seeds, canola oil, and others.
• Probiotics. Supply normal microbes needed for colon health and health of the body such as these fermented foods: yogurt, kefir, and unpasteurized apple cider vinegar.
• Prebiotics/ High Fiber Foods.  Food with fiber keeps our population of colonic microbes healthy.
• Protective Herbs and Spices.  See below #6 below for examples.[/box]

• [dropcap]3[/dropcap] Information Sheet You Can Take to Your Doctor or Other Health Professional:

Click here.

• [dropcap]4[/dropcap] Manage Your Medications Safely:

[box type=”shadow” ]

Certain medications cause deficiency of folic acid that is a cause of epilepsy with cerebral calcifications.  Ask your doctor or pharmacist about this possible adverse effect if you are taking any of the drugs listed below. Do not stop prescribed medications without supervision.

This is not a complete listing.

ANTACIDS / ULCER MEDICATIONS

• Pepcid®, Tagamet®, Zantac® deplete Folic Acid.
• Magnesium and Aluminum Antacid preparations (Gaviscon®, Maalox®, Mylanta®) Folic Acid.
• Alka Seltzer®, Baking Soda deplete Folic Acid.

ANTI-INFLAMMATORIES disrupt intestinal permeability which complicates celiac disease.

• Corticosteroids (Prednisone, Medrol®, Aristocort®, Decadron) deplete Folic Acid.
• NSAIDS (Motrin®, Aleve®, Advil®, Anaprox®, Dolobid®, Feldene®, Naprosyn® and others) deplete Folic acid.
• Aspirin and Salicylates deplete Folic Acid.

ANTICONVULSANTS

• Phenobarbital and Barbituates; and Dilantin®, Tegretol®, Mysoline®, Depakane/Depacon® deplete Folic Acid.

CHOLESTEROL DRUGS

• Colestid® and Questran® deplete Folic Acid.

DIABETIC DRUGS 

• Metformin® depletes Folic acid.

DIURETICS

• Potassium Sparing Diuretics (Midamor®, Aldactone®, Dyrenium® and others) deplete Folic Acid.

FEMALE HORMONES disrupt intestinal permeability which complicate celiac disease.

• Oral Contraceptives (Norinyl®, Ortho-Novum®, Triphasil®, and others) deplete Folic Acid.
• Oral Estrogen/Hormone Replacement (Evista®, Prempro®, Premarin®, Estratab® and others) deplete Folic Acid.[/box]

• [dropcap]5[/dropcap]Nutritional Supplements To Help Correct Deficiencies:

[box type=”shadow” ]

The type and quantity of nutritional supplements that may be needed depend on which nutrients are deficient.

• Multivitamin/mineral combination once a day is useful to improve overall nutrient levels. This is a safe dose, but always check with your doctor to avoid interactions with medications.
• Folic acid as prescribed.

Storage Note: Store container tightly sealed, away from heat, moisture and direct light to avoid loss of potency. That is, in a safe kitchen cabinet – not in the bathroom or on the kitchen table.[/box]

• [dropcap]6[/dropcap]Manage Natural Remedies: 

[box type=”shadow” ]Hydration:

• Eight glasses of water are recommended per day unless there is a contraindication such as kidney or heart disease. The Institute of Medicine recommends approximately 2.7 liters (91 ounces) of total water, from all beverages and foods, each day for women and 3.7 liters (125 ounces) daily of total water for men.
• If you are thirsty, drink water. Add fresh, squeezed lemon to water. Lemon is anti-inflammatory, alkalizing and provides vitamin C.
• Hydration Test: Urine should be pale yellow. Fingertips should be plump, without pruning but this may not be reliable when fingers are swollen with edema. Lips should be plump, without puckering. The feeling of thirst can be unreliable.
• What is wrong with soda, coffee, tea, and alcohol? These drinks are dehydrating, increase acid, and deplete nutrients.[/box]

[box type=”shadow” ]Carminatives. The following  anti-inflammatory plant sources called carminitives help heal the digestive tract. They also tone the digestive muscles which improves peristalsis, thus aiding in the expulsion of gas from the stomach and intestine to relieve digestive colic and gastric discomfort.

Carminative Food Remedies:

• Raspberry.
• Carrot is also a cleansing digestive tonic.
• Grape is also bile stimulating and a cleansing remedy for sluggish digestion and laxative.
• Redbeets also stimulate and improve digestion and are easily digested.
• Cabbage also stimulates and improves digestion and is also a liver decongestant.
• Lettuce also stimulates and improves digestion and is also an alterative, meaning it improves the function of organs involved with the digestion and excretion of waste products to bring about a gradual change.
• Potatoes are antispasmodic (due to atropine like properties) and a liver remedy.

Carminative Herb Remedies:

• Sage is also a digestive, astringent, bile stimulant and energy tonic that heals the mucosa.  Drink as tea or use in cooking.
• Chamomile, lemon balm, and fennel, (as a tea) also help relieve nervous tension.
• Parsley also relieves indigestion.
• Rosemary as a tea and in cooking also is a nervous system tonic for stress and fatigue, bile stimulant, and can relieve headaches and indigestion.
• Thyme is also soothing remedy useful for stimulating digestion of rich, fatty foods.

Carminative Spice Remedies:

• Cloves are also antispasmodic.
• Nutmeg is also useful for indigestion.
• Ginger.[/box]

[box type=”shadow” ]Exercise Helps:

Exercise improves circulation and rids the body of toxins.

• Walking is aerobic exercise that reconditions the whole body to improve stamina. Read more about Exercise and Fitness.
• Weight training builds muscle. Read more about Exercise and Fitness.
• Stretching improves flexibilty. Read more about Exercise and Fitness.

Note: Exercise is important, but the amount and type of exercise undertaken depends on your health. Your first priority is to heal. [/box]

What Do Medical Research Studies Tell About Occipital Lobe Epilepsy With Cerebral Calcifications In Celiac Disease and/or Gluten Sensitivity?

RESEARCH STUDY SUMMARIES

“Celiac disease with neurologic manifestations in children.” This study investigating the incidence of neurologic manifestations in 48 children aged 2-18 years diagnosed with celiac disease found that 16 children presented one or more neurologic symptoms as the onset manifestation of celiac disease. The neurologic signs in order of frequency were: headache/migraine, attention-deficit/hyperactivity disorder, epileptic seizures, mental retardation, cerebellar ataxia and behavior disorders. Brain CT-scan showed cerebral calcifications in 3 patients with epilepsy, and atrophy in 2 cases with cerebellar ataxia.

The diagnosis of celiac disease was made by serological tests and intestinal biopsy. The study protocol included: measurement of weight and height, biological and immunological tests, histological examination, questionnaires filled out by parents about their child motor development and some neurologic signs, psychological exam, electroencephalogram, and brain CT-scan.

Over a ten year period of follow-up, all children received gluten free diet, but a favorable course was noticed only in the children with migraine and epilepsy, in the other patients this diet having no influence on neurologic symptoms.

This study proved the variety of neurologic symptoms that can be included in the clinical signs of celiac disease in pediatric patients. That is why in the presence of different neurologic symptoms of unknown etiology and resistant to treatment, celiac disease must be taken into account and laboratory investigations have to include intestinal biopsy and immunological test.⁷

CASE REPORT SUMMARIES

“CEC syndrome–a rare manifestation of coeliac disease.” This case report of uncovering celiac disease in a thirty-six year old lady who presented following two episodes of facial numbness of ten minutes duration, one of which was associated with blurred vision. There was a three-kilogram weight loss over six months and there was no significant past medical history. Clinical examination was unremarkable.

Routine blood investigations revealed a mildly decreased folate level and a CT scan of the brain revealed cortical-based bilateral serpiginous calcification. An MRI scan showed no evidence of Sturge-Weber syndrome, a prominent cause of cerebral calcification, which is characterised by prominent deep cerebral veins, focal atrophy, ipsilateral choroid plexus enlargement and enhancement at the sites of calcification. On further investigation coeliac disease was confirmed by a raised serum anti-transglutaminase and anti-endomysial anti-bodies, and villous atrophy and intra-epithelial lymphocytes on duodenal biopsy. A gluten-free diet was commenced and there were no subsequent similar symptoms. A diagnosis of incomplete CEC syndrome (celiac epilepsy and cerebral calcifications) was reached on the basis of radiological and clinical findings.

Reduced central nervous system folate levels secondary to folate malabsorption is a suggested mechanism of calcification in CEC syndrome5 as folate deficiency is seen in all major causes of cerebral calcification.⁸

“Epilepsy, cerebral calcifications and celiac disease. The importance of an early diagnosis.” This case report of three school age boys who presented with partial seizures with visual symptoms describes subsequent diagnosis of Celiac Disease based on positive serology and small intestinal biopsy showing grade 3 severe enteropathy. A tomography scan of the head revealed bilateral occipital calcifications in all cases. All 3 patients, following a Gluten Free Diet and taking anti-convulsants, were free of seizures in the follow-up (1,2, and 8 years). Investigators concluded that it is of vital importance to investigate Celiac Disease in any patient with epilepsy and occipital calcifications, even in the absence of GI symptoms, since early diagnosis and treatment with exclusion of gluten affect how the syndrome courses later on.¹

“Visual distrubances representing occipital lobe epilepsy in patients with cerebral calcifications and celiac disease: a case series.” This case report of three Australian patients with seizure types including simple partial, complex-partial, and secondarily generalized seizures illustrates the association between seizures of occipital origin, cerebral calcifications, and Celiac Disease even in patients not of Mediterranean origin. The seizure semiology consisted of visual disturbances such as blurred vision, loss of focus, seeing colored dots, and brief stereotyped complex visual hallucinations like seeing unfamiliar faces or scenes. Symptoms of malabsorption were not always present. Routine EEG was unremarkable. In all cases, CT demonstrated cortical calcification of the occipital-parietal regions. Magnetic imaging showed no additional lesion. All patients had biopsy confirmed Celiac Disease. Seizure control improved after treatment with Gluten Free Diet and anticonvulsant medication.⁹

Sources:

1. Diaz RM, Gonzalez-Rabelino G, Delfino A. Epilepsy, cerebral calcifications and coeliac disease. The importance of an early diagnosis. Revista de Neurologia. Apr 1-15, 2005;40(7):417-20. [↩] [↩]
2. Pfaender M, D’Souza WJ, Trost N, Litewka L, Paine M, Cook M. Visual distrubances representing occipital lobe epilepsy in patients with cerebral calcifications and coeliac disease: a case series. Journal of Neurology, Neurosurgery, and Psychiatry. Nov 2004;75(11):1623-5. [↩]
3. Sunnikutty AP, Harding J, Nelson JC. CEC syndrome–a rare manifestation of coeliac disease. Ulster Med J. 2008 Sep;77(3):205-6. [↩] [↩]
4. Pfaender M, D’Souza WJ, Trost N, Litewka L, Paine M, Cook M. Visual disturbances representing occipital lobe epilepsy in patients with cerebral calcifications and celiac disease: a case series. Journal of Neurology, Neurosurgery, and Psychiatry. Nov 2004;75(11):1623-5. [↩]
5. Cummins AG, Thompson FM, Butler RN, et al. Improvement in intestinal permeability precedes morphometric recovery of the small intestine in coeliac disease. Clinical Science. Apr 2001;100(4):379-86. [↩]
6. Farhadi A, Banan A, Fields J, Keshavarzian A. Intestinal barrier: an interface between health and disease. Journal of Gastroenterology and Hepatology. 2003;18:479-91. [↩] [↩] [↩] [↩] [↩] [↩]
7. Diaconu G, Burlea M, Grigore I, Anton DT, Trandafir LM. Celiac disease with neurologic manifestations in children. Rev Med Chir Soc Med Nat Iasi. 2013 Jan-Mar;117(1):88-94. [↩]
8. Sunnikutty AP, Harding J, Nelson JC. CEC syndrome–a rare manifestation of coeliac disease. Ulster Med J. 2008 Sep;77(3):205-6. [↩]
9. Pfaender M, D’Souza WJ, Trost N, Litewka L, Paine M, Cook M. Visual disturbances representing occipital lobe epilepsy in patients with cerebral calcifications and celiac disease: a case series. Journal of Neurology, Neurosurgery, and Psychiatry. Nov 2004;75(11):1623-5. [↩]