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Patients with idiopathic cerebellar ataxia may be affected by subclinical celiac disease (CD), with or without typical features of CD at duodenal biopsy.1,2 The efficacy of a gluten-free diet in improving neurologic complications of CD is controversial. We describe clinical and electrophysiologic improvement in a patient with ataxia and peripheral neuropathy associated with subclinical CD after 2 years of a gluten-free diet.
Case report.
A 34-year-old man was first observed in June 1994 with a 7-year history of slowly progressive ataxia. Neurologic examination revealed wide-based gait, positive Romberg’s sign, horizontal nystagmus on lateral gaze, mild dysarthria, dysmetria in right upper limb and lower limbs, and brisk reflexes in lower limbs with mild spasticity. Results of sensory examination and muscle strength were normal. Plantar responses were flexor. The patient’s score on the Inherited Ataxias Clinical Rating Scale (IACRS)3 was 10. Brain MRI showed vermian atrophy. Neurophysiologic data are summarized …
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