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Gluten Ataxia Symptoms

Problems with Gait, Tingling in Extremities, Other Signs Common

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Updated June 17, 2014

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

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Gluten ataxia symptoms can include loss of balance and nerve damage in your legs and arms

Getty Images/Juanmonino

Symptoms of gluten ataxia can range from progressive balance difficulties and unsteadiness on your feet to problems swallowing. You might have double vision, or even issues controlling your bladder. Your symptoms might come on slowly or might appear suddenly, but probably won't include gastrointestinal symptoms that could indicate celiac disease.

Researchers are only beginning to define gluten ataxia, and not all mainstream physicians agree that it's a valid diagnosis. In addition, there are no recognized medical tests to diagnose gluten ataxia, although the top researchers in the field of celiac disease and gluten sensitivity have proposed a diagnostic procedure.

Nonetheless, various medical studies have outlined the symptoms of gluten ataxia, and have speculated on how many people might have gluten ataxia.

Gluten Ataxia Symptoms Include Gait Problems, Unsteadiness

The symptoms of gluten ataxia are identical to those of other forms of ataxia, making it more challenging to provide a proper diagnosis. Gluten ataxia patients generally are in their late 40s or early 50s when diagnosed, although the medical literature notes several cases where the condition develops in young children or teens. Men and women are fairly equally represented.

In most cases, people notice problems with their gross motor skills first — in other words, they'll be very clumsy, they'll walk unsteadily with a tendency to stumble or make missteps, and they'll generally be extremely uncoordinated.

Gluten ataxia sufferers may also notice problems with fine motor skills — for example, someone with the condition might be unable to easily button a shirt or use a pen to write in longhand. Some patients also slur their words or have trouble speaking, and some have difficulty swallowing.

Medical studies report that everyone with gluten ataxia has symptoms of gait ataxia, and that these problems often go hand-in-hand with gluten-related peripheral neuropathy symptoms (i.e., tingling in your extremities). About 80% have problems with their eyes, in which their eyes move involuntarily back and forth.

Approximately 60% of patients show evidence of what's called "sensorimotor axonal neuropathy," which means nerve damage that causes sensations of tingling, loss of sensation and even pain in the extremities. However, these symptoms usually are mild, and don't necessarily contribute to the ataxia, researchers say.

Despite the potentially gluten-induced nature of the damage to their bodies, only around 10% of people with gluten ataxia will have gastrointestinal symptoms such as diarrhea, constipation, bloating, abdominal pain, gas and reflux. Despite this low level of symptoms, one study found that 24% of gluten ataxia patients actually had villous atrophy from celiac disease.

Symptoms Reflect Damage To Your Brain

All these gluten ataxia symptoms stem from damage to your cerebellum, the part of your brain charged with making sure your muscles work in concert with each other.

In fact, 60% of patients diagnosed with gluten ataxia have evidence of cerebellar atrophy — literally, shrinkage of that part of their brains — when they're examined by magnetic resonance imaging (MRI). Patients who don't have visible shrinkage in their cerebellums still show abnormalities in highly sensitive medical imaging studies, according to researchers.

The condition tends to progress slowly, but it is possible for it to move rapidly, too, with cerebellar atrophy developing within a year of the first symptoms, according to Dr. Marios Hadjivassiliou, a neurologist practicing in the U.K. and the top researcher in the field of gluten ataxia.

A study performed by Dr. Hadjivassiliou looking at 68 patients with gluten ataxia noted that 78% of those people carried one or both of the primary celiac disease genes, HLA-DQ2 and HLA-DQ8. The remainder of that group carried HLA-DQ1, which Dr. Hadjivassiliou has speculated is involved with neurological symptoms stemming from gluten ingestion.

Gluten Ataxia Symptoms, Diagnosis Not Straightforward

In a paper published in the journal BMC Medicine in February 2012, Dr. Hadjivassiliou and other top researchers outlined the most common symptoms of gluten ataxia and proposed a diagnostic algorithm designed to distinguish the condition from the other gluten- and wheat-related conditions: celiac disease, gluten sensitivity, dermatitis herpetiformis and wheat allergy.

More on diagnosis: Gluten Ataxia Diagnosis

However, more research and consensus will be needed before clinicians will fully accept gluten ataxia as a diagnosis, and routinely test people for it if they show symptoms.

Sources:

Bushara K. Neurologic presentation of celiac disease. Gastroenterology. 2005 Apr;128(4 Suppl 1):S92-7.

Fasano A. et al. Spectrum of gluten-related disorders: consensus on new nomenclature and classification. BMC Medicine. BMC Medicine 2012, 10:13 doi:10.1186/1741-7015-10-13. Published: 7 February 2012

Hadjivassiliou M. et al. Dietary Treatment of Gluten Ataxia. Journal of Neurology, Neurosurgery and Psychiatry. 2003;74:1221-1224.

Hadjivassiliou M. et al. Gluten sensitivity as a neurological illness. Journal of Neurology, Neurosurgery and Psychiatry. 2002;72:560-563 doi:10.1136/jnnp.72.5.560.

Hadjivassiliou M. et al. Gluten ataxia in perspective: epidemiology, genetic susceptibility and clinical characteristics. Brain. 2003 Mar;126(Pt 3):685-91.

Hadjivassiliou M. et al. Gluten Ataxia. The Cerebellum. 2008;7(3):494-8.

Rashtak S. et al. Serology of celiac disease in gluten-sensitive ataxia or neuropathy: role of deamidated gliadin antibody. Journal of Neuroimmunology. 2011 Jan;230(1-2):130-4. Epub 2010 Nov 6.

Zelnik N. et al. Range of neurologic disorders in patients with celiac disease. Pediatrics. 2004 Jun;113(6):1672-6.

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