Silent celiac disease in patients with childhood localization-related epilepsies

Purpose: To evaluate how many patients with a clinical picture of idiopathi c childhood localization-related epilepsies may also have silent celiac dis ease (CD). This will help determine whether investigation for CD should be restricted to those patients with childhood partial epilepsy with occipital paroxysms (CPEO) or should be extended to all patients with childhood part ial epilepsy (CPE) regardless of seizure type and electroencephalographic ( EEG) paroxysms. Methods: The study group consisted of 72 patients (31 girls and 41 boys; me an age, 12.6 +/- 4.28 years; age at onset, 6.4 +/- 3.7 years) who were obse rved consecutively over a 5-year period and who received an initial diagnos is of idiopathic CPE. A diagnosis of CID was confirmed by using enzyme-link ed immunosorbent assay (ELISA) to assess the presence of antigliadin antibo dies and the immunofluorescent undirected test to assess the presence of an tiendomysium antibodies. Results: Twenty-five patients had CPEO, whereas the remaining 47 had CPE wi th centrotemporal spikes (CPEC). None of the patients with CPEC had positiv e antibody tests. Of the 25 patients with CPEO, two (8%) had antiendomysium immunoglobulin (Ig) A antibodies. In both of these patients, the jejunal b iopsy showed atrophy of the villi and hyperplasia of the crypts, consistent with a diagnosis of CD. Brain computed tomography (CT) was normal in one o f these patients and revealed occipital corticosubcortical calcifications i n the other. Conclusions: Our study indicates that CD screening should be performed rout inely only in patients with CPEO.