ADULT CELIAC-DISEASE REVEALED BY A SENSOR Y-MOTOR NEUROPATHY

Central or peripheral nervous system complications are occasionally ob served in adult patients with celiac disease. Several mechanisms have been proposed including vitamin deficiency, vascular inflammation and a direct effect of gluten intolerance. Typical nerve fiber damage due to demyelinization. has been suggested. We observed a 65-year old woma n with a right peroneal nerve palsy superimposed on a diffuse peripher al neuropathy who was found to have folic acid deficiency which in tur n led to the diagnosis of adult celiac disease. Electrophysiological a nd histological studies demonstrated a predominantly demyelinating per ipheral neuropathy which responded first to parenteral folic acid supp lementation and second to a gluten-free diet. The mechanisms of periph eral nerve damage in adult celiac disease are briefly discussed and th e possible role of folic acid deficiency is emphasized.