SPRUE WITH OCCIPITAL CALCIFICATIONS - 2 L ATE CASES

The association of celiac disease, epilepsy and occipital calcificatio ns with initial clinical manifestations of epilepsy during the first t wo decades of life with an often progressive and variable course and c linical expression of malabsorption has recently been described. Two c ases of celiac disease with occipital calcifications and a presentatio n with neurologic symptoms in adulthood are reported. The first case i s that of a 40-year-old male who presented recurrent and alternating p ure brachial monoparesia and later acute abdominal pain following whic h celiac sprue was diagnosed. The second case is that of a 53-year-old woman diagnosed with celiac sprue 20 years before, presenting permane nt myoclonus in the lower limbs which were progressive in severity, at axic march and generalized tonicoclonic seizures, Both patients had bi lateral occipital calcifications on CT and celiac disease was demonstr ated on biopsy. The first case also showed marked signal alteration in the white matter on MRI. Celiac disease with cerebral calcifications presents also in adulthood with atypical clinical manifestations. Susp icion of celiac disease may be confirmed by non-invasive methods such as antigliadin and antiendomysium antibody determination. CT imaging i s characteristic.