Journal
NATURE CLINICAL PRACTICE NEUROLOGY
Volume 3, Issue 10, Pages 581-584Publisher
NATURE PUBLISHING GROUP
DOI: 10.1038/ncpneuro0631
Keywords
amyotrophic lateral sclerosis; antigliadin antibodies celiac disease; hemiparesis; MRI
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Background A 44-year-old male presented to a general neurology clinic with a 6-month history of progressive right-sided spastic hemiparesis without sensory symptoms or signs. The thigh muscle in the affected leg showed signs of wasting. The patient had a remote family history of celiac disease. Investigations Neurological examination, neurophysiological studies, brain MRI scan, routine blood tests, duodenal biopsy, cerebrospinal fluid analysis including polymerase chain reaction test for JC virus DNA, serological testing for HIV and for the presence of serum antibodies to endomysium, gliadin and tissue transglutaminase. Diagnosis Celiac disease with neurological involvement, mimicking amyotrophic lateral sclerosis. Management Strict gluten-free diet.
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