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?
[dropcap]G[/dropcap]ait ataxia is a cerebellar (lower brain) disorder characterized by defective muscular coordination of skeletal muscles used for locomotion (walking).
Q: What is defective muscle coordination for walking?
A: The cerebellum does not initiate movements but is responsible for the coordinated execution of voluntary muscle movements by means of a complex interplay with many brainstem structures. Whatever alters this cerebellar function produces defective muscle coordination needed for walking.
What Is Gait Ataxia In Celiac Disease and/or Gluten Sensitivity?
Brain scan showing ataxia. Notice the space between the brain and the skull that shows tissue loss.Courtesy Wikimedia
What Is Gluten Ataxia?
[dropcap]G[/dropcap]luten ataxia is a degeneration of the cerebellum (lower brain) caused by an immune reaction to gluten that is characterized by positive anti-gliadin antibodies, motor abnormalities including upper or lower limb ataxia, gait ataxia, and dysarthria (impaired muscles for producing speech). Ataxia involves lack of coordination in purposeful movements of the body like lifting objects and walking.1
In addition to anti-gliadin antibodies, patients with gluten ataxia have oligoclonal bands in their cerebrospinal fluid, inflammation at the cerebellum, and anti-Purkinje cell antibodies.1
The duration of immune reactivity to gluten that results in Purkinje cell damage in the cerebellum correlates with the severity and the presence of cerebellar atrophy (loss of brain tissue).2 That is, more gluten damages more brain cells.
Studies suggest that persons with gluten ataxia may have additional antibodies that react with Purkinje cells and are not present in patients with anything other than gluten ataxia alone. It seems likely that the Purkinje cells of the cerebellum share epitopes with gliadin proteins.1
Q: What is Purkinje cell damage?
A: Purkinje cell damage is a finding commonly encountered in cerebellar degeneration. Purkinje cells are large flask-shaped neurons lying between the molecular and granular layer of the cerebellar cortex (outer layer) that have dendrites (branched processes of the cell body that conduct messages to the cell body) extending to the cortex of the cerebellum and into the white matter of the brain.
Purkinje cells are sensitive to vitamin E status in the body.
What Is Gluten Ataxia In Celiac Disease and/or Gluten Sensitivity?
Sources:
Jessica R. Jackson, William W. Eaton, Nicola G. Cascella, Alessio Fasano, and Deanna L. Kelly Neurologic and Psychiatric Manifestations of Celiac Disease and Gluten Sensitivity. Psychiatr Q. Mar 2012; 83(1): 91–102. doi: 10.1007/s11126-011-9186-y [↩] [↩] [↩]
Hadjivassiliou M, Grunewald RA, Chattopadhyay AK, et al. Clinical, radiological, neurophysiological, and neuropathological characteristics of gluten ataxia. Lancet. Nov 14, 1998;352(9140):1582-5. [↩]
[dropcap]C[/dropcap]horea is a movement disorder characterized by brief, jerky, purposeless or writhing involuntary movements of the distal limbs, head, and face that may occur during voluntary movement or at rest.
Chorea has a large number of causes, including metabolic, structural, pharmacologic, genetic, and autoimmune factors. Despite extensive investigations, many patients remain undiagnosed.1
What Is Chorea In Celiac Disease and/or Gluten Sensitivity?
Sources:
Walker RH. Further Evidence for Celiac Disease-associated Chorea. Tremor Other Hyperkinet Mov (N Y). 2011;1. pii: tre-01-32-96-3. [↩]
Comparison of Brain Atrophy. Courtesy: csua.berkeley.edu
What Is Brain Atrophy?
[dropcap]B[/dropcap]rain atrophy is a degenerative condition of the brain characterized by loss of brain tissue, causing the brain to shrink.
Q: How does loss of brain tissue affect the body?
A: Loss of brain tissue will result in dysfunction depending on the area of the brain that is affected.
For example, loss of brain tissue in the lower brain, or cerebellum, will impair muscle coordination in activities such as walking, while loss of brain tissue in the frontal lobes of the cerebrum will impair cognition such as thinking, judgment, analysis, mathematical ability, and memory.
What Is Brain Atrophy In Celiac Disease and/or Gluten Sensitivity?
[dropcap]B[/dropcap]rain blood flow abnormalities, or cerebral perfusion abnormalities, such as spasm of blood vessels causing inadequate blood flow to the brain, are characterized by impaired brain function and thinking.
Q: What is cerebral perfusion?
A: Cerebral perfusion is the flow of blood in the brain. Blood supply to the brain comes from 4 major vessels: 2 carotid arteries and 2 vertebral arteries.
Cerebral perfusion abnormalities can be diagnosed using perfusion computed tomography (CT). CT scan is a technique that allows rapid qualitative and quantitative evaluation of cerebral perfusion by generating maps of cerebral blood flow (CBF), cerebral blood volume (CBV), and mean transit time (MTT). The technique is based on the central volume principle (CBF = CBV/MTT) and requires the use of commercially available software employing complex deconvolution algorithms to produce the perfusion maps.
Perfusion CT has been found to be useful for noninvasive diagnosis of cerebral ischemia (diminished blood flow) and infarction (no blood flow) and for evaluation of vasospasm (intermittent blood flow through vessels).1
What Are Brain Blood Flow Abnormalities In Celiac Disease and/or Gluten Sensitivity?
Sources:
Hoeffner E, Case I, Jain R, et al. Cerebral Perfusion CT: Technique and Clinical Applications. June 2004 Radiology, 231, 632-644. [↩]
A. CT scan shows coarse calcification. B. MRI shows frontal atrophy (shrinkage). C: Intra-operative angiomatosis. Courtesy intechopen.com “Epilepsy Surgery in Children” by V. Terra, A Sakamoto, H. Machado
What Is Cortical Calcifying Angiomatosis?
[dropcap]C[/dropcap]ortical calcifying angiomatosis is a cortical vascular (brain blood vessel) abnormality that is characterized by calcification of blood vessels and is usually present in the parietal or occipital cortical and subcortical regions of the brain.1
The brain has 2 sides or hemispheres. Each side has 4 lobes, making 8 lobes altogether: 2 frontal lobes behind the forehead, 2 temporal lobes at ear level, 2 occipital lobes make up the rear of the brain, and 2 parietal lobes located behind the frontal lobes and above the temporal lobes.
Q: How do calcifications of blood vessels appear?
A: Calcium deposits are jagged owing to natural crystal formation by calcium, which is a mineral.
What Is Cortical Calcifying Angiomatosis In Celiac Disease and/or Gluten Sensitivity?
Sources:
Wills AJ. The neurology and neuropathology of celiac disease. Neuropathology and Applied Neurobiology. 2000:26:493-496. [↩]
Image of Migraine Development. Courtesy wikimedia.
What Is Migraine?
[dropcap]M[/dropcap]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:
Kelman L. The triggers or precipitants of the acute migraine attack. Cephalalgia. 2007 May;27(5):394-402. Epub 2007 Mar 30. [↩]
[dropcap]A[/dropcap]norexia or loss of appetite is a reduced desire to eat which can cause unintentional weight loss.
Anorexia is a feature of many disorders caused by malutrition such as celiac disease and aging or gastrointestinal problems such as chronic gastroenteritis, and dysgeusia (loss of taste).
Q: Are there other conditions that cause anorexia?
A: Other underlying problem include medication side effects, infection, chronic pain, depression, grief, dehydration, hormonal dysfunction such as thyroid disease, primary hyperparathyroidism, or Addison’s disease, autoimmune mechanisms such as sarcoidosis, and cancer growth.
What Is Anorexia In Celiac Disease and/or Gluten Sensitivity?
