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Dementia

DementiaWhat Is Dementia?

[dropcap]D[/dropcap]ementia is the term used to describe a group of symptoms that show significant deterioration of an individual’s intellectual and social abilities.

The deterioration in intellectual function is progressive and is characterized by memory and cognitive impairment involving deficits in reasoning, judgment, abstract thought, comprehension, learning, use of language, and task execution.

Some types of dementia can be reversed,  while most types of dementia are degenerative or nonreversible.

Q: What causes dementia?

A: There are  many differing causes of dementia.  Here are some causes according to nonreversible and reversible:

  • Nonreversible dementia may not be turned back due to these conditions:
  • Alzheimer’s disease is the most common type of degenerative dementia caused by abnormal protein structures in certain areas of the brain. 
  • Lewy body disease is a leading cause of dementia in elderly adults.
  • Vascular dementia due to many small strokes.
  • Medical conditions: Huntington’s disease, multiple sclerosis, infections that can affect the brain, such as HIV/AIDS and Lyme disease, Parkinson’s disease, Pick’s disease, and progressive supranuclear palsy.
  • Reversible dementia may be stopped or reversed if these conditions are found soon enough:
  • Brain injury.
  • Brain tumors.
  • Chronic alcohol abuse.
  • Changes in blood sugar, sodium, and calcium levels.
  • Changes that can occur with celiac disease, diabetes, thyroid disease, and other metabolic disorders.
  • Nutritional deficiencies.
  • Use of certain medications, including cimetadine and some cholesterol-lowering medications.1

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

Sources:
  1. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001748/ [↩]

Chronic Fatigue Syndrome 

What Is Chronic Syndrome Fatigue? [dropcap]C[/dropcap]hronic fatigue syndrome is a debilitating illness characterized by persistent or relapsing overwhelming and incapacitating fatigue not relieved by rest, having a definite onset and often accompanied by numerous symptoms… 

Headache (Emicrania)

headache gluten celiac disease symptomWhat Is Headache Or Emicrania?

[dropcap]E[/dropcap]micrania is a headache resulting from stimulation of, or traction of, or pressure on any of the pain sensitive structures of the head characterized by pain felt anywhere in the head.

In addition to gluten sensitivity and nutritional deficiencies, there are many causes of headache including cardiac, cerebral, vascular, psychiatric, metabolic, and neurologic diseases. Recent studies have highlighted that obesity is significantly associated with headache and disability in adults. This rule also applies to children.1

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

Sources:
  1. Laino D, Vitaliti G, Parisi P,   et. al. Headache, migraine and obesity: an overview on plausible links. J Biol Regul Homeost Agents. 2016 Apr-Jun;30(2):333-8. [↩]

Chronic Fatigue / Lassitude / Tiredness

Chronic FatigueWhat Is Chronic Fatigue?

[dropcap]C[/dropcap]hronic fatigue or lassitude is a state of weariness not relieved by rest and the inability to do normal physical or mental work.

Q: What are causes of chronic fatigue?

A: Chronic fatigue can be a feature of many disorders including nutritional problems like poor diet or malabsorption, sleep problems, systemic conditions like anemia or heart disease, respiratory disorders like COPD or asthma, infectious disease like tuberculosis, endocrine disorders like diabetes, autoimmune disease like thyroid disease, and cancer.

Fatigue greatly reduces quality of life in all aspects including the desire and ability to socialize and find fullfillment in new and interesting ways.

What Is Chronic Fatigue In Celiac Disease and/or Gluten Sensitivity?

Multiple Sclerosis

Brain scan showing changes in multiple sclerosis over a month. Courtesy Wikimedia
Brain scan showing changes in multiple sclerosis by month over a year’s time. Courtesy Wikimedia

What Is Multiple Sclerosis?

[dropcap]M[/dropcap]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. [↩]

Vasculitis, Cerebral (Cause of Stroke, TIA, and Seizure)

How Vasculitis Develops. Courtesy quizlet.com
How Vasculitis Develops. Courtesy quizlet.com

What Is Cerebral Vasculitis?

[dropcap]C[/dropcap]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. [↩]

Tremors

hand-tremorWhat Are Tremors?

[dropcap]T[/dropcap]remors are repetitive patterns of involuntary muscle contraction and relaxation originating from disorder in the basal ganglia of the brain. See image of hand tremor (to left) courtesy of Antonio Piedade.

Rythmic shaking may affect various parts of the body including hands, arms, legs, trunk, tongue, or vocal cords.1

Causes include malnutrition, drug adverse effects especially antipsychotics, environmental toxins, and conditions such as Parkinson disease and thyroid disease, which causes toxic levels of thyroid hormone.

What Are Tremors In Celiac Disease and/or Gluten Sensitivity?

Sources:
  1. http://www.ninds.nih.gov/disorders/tremor/detail_tremor.htm [↩]

Progressive Multifocal Leukoencephalopathy

View of Progressive Leukoencephalopathy. Courtesy quizlet.com.
View of Progressive Multifocal Leukoencephalopathy. Courtesy quizlet.com.

What Is Progressive Multifocal Leukoencephalopathy?

[dropcap]P[/dropcap]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. [↩]

Migraine (Headache)

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

Occipital Lobe Epilepsy With Cerebral Calcifications

CT scan showing brain calcifications. Courtesy Wikimedia
CT scan showing brain calcifications. Courtesy Wikimedia

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.                                                                                      Drawing shows the 4 lobes of the human brain on the left side. The occipital lobe is pink. Courtesy Wikimedia

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