Celiac disease and headache in children: a narrative state of the art Celiac disease and headache

Main Article Content

Luca Sabino
Silvia Marino
Raffaele Falsaperla
Francesco Pisani
Carmen Massimino
Piero Pavone

Keywords

Celiac disease, childhood , headache, therapy

Abstract

Celiac disease (CD) is one of the most important entity of the wide spectrum of gluten-related disorders (GRDs). It is well known that neurological manifestation can be present either at the onset of CD, or appear during the development of the pathology, and different can be the neurologic findings. Clinical features are very variable, ranging from typical manifestations of gastrointestinal involvement to neurologic symptom. The most frequent neurologic signs reported were headache, epileptic seizure, migraine, mental retardation, ataxia and attention deficit and hyperactive disorder. Headache either in form of migraine, or in non-specific form represents one of the main clinical presentation in CD. The aim of this work is to provide a narrative review of the pediatric literature focused on the cephalalgic features of children with CD evaluating the potential benefits of a gluten free diet (GFD).  Papers were identified by searching for related literature in Medline (PubMed) and Embase using the words “Celiac Disease” and “Headache” or “Migraine” by specifying “children”/“paediatric age” for reports published since 1972 till 31th October 2018. According to our inclusion criteria, a total of 25 papers has been evaluated. Although it is still controversial if headache is prevalent in CD children a correct compliance to a GFD seems to improve the neurological symptoms even if the underlying pathogenic relationship between CD and neurologic system involvement is still not fully understood.

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References

1. Pennisi M, Bramanti A, Cantone M, Pennisi G, Bella R, Lanza G. Neurophysiology of the "Celiac Brain": Disentangling Gut-Brain Connections. Front Neurosci. 2017 Sep 5;11:498
2. Zis P, Julian T, Hadjivassiliou M. Headache Associated with Coeliac Disease: A Systematic Review and Meta-Analysis. Nutrients. 2018 Oct 6;10(10).
3. Işikay S, Kocamaz H. The Neurological Face Of Celiac Disease. Arq Gastroenterol. 2015;52:167-70.
4. Lionetti E, Francavilla R, Pavone P, Pavone L, Francavilla T, Pulvirenti A, Giugno R, Ruggieri M. The neurology of coeliac disease in childhood: what is the evidence? A systematic review and meta-analysis. Dev Med Child Neurol. 2010;52:700-7.
5. Balcı O, Yılmaz D, Sezer T, Hızlı Ş. Is Celiac Disease an Etiological Factor in Children With Migraine? J Child Neurol. 2016;31:929-31.
6. Sapone A, Bai JC, Ciacci C et al. Spectrum of gluten-related disorders: consensus on new nomenclature and classification. BMC Med. 2012;10:13.
7. Lionetti E, Castellaneta S, Francavilla R et al. Introduction of gluten, HLA status, and the risk of celiac disease in children. SIGENP (Italian Society of Pediatric Gastroenterology, Hepatology, and Nutrition) Working Group on Weaning and CD Risk. N Engl J Med. 2014;371:1295-303.
8. Prinzbach A, Moosavinasab S, Rust S et al. Comorbidities in Childhood Celiac Disease: A Phenome Wide Association Study Using the Electronic Health Record. J Pediatr Gastroenterol Nutr. 2018; 67:488-493.
9. Spagnoli C, Pisani F, Di Mario F, Leandro G, Gaiani F, De' Angelis GL, Fusco C. Peripheral neuropathy and gastroenterologic disorders: an overview on an underrecognized association. Acta Biomed. 2018;89 (9-S):22-32.
10. Mustalahti K, Catassi C, Reunanen A, et al. The prevalence of celiac disease in Europe: results of a centralized, international mass screening project. Ann Med. 2010; 42:587–595.
11. Ivarsson A, Myléus A, Norström F, et al. Prevalence of childhood celiac disease and changes in infant feeding. Pediatrics. 2013; 131:e687–e694.
12. Bushara KO. Neurologic presentation of celiac disease. Gastroenterology. 2005;128:S92-7.
13. Petrarca L, Nenna R. Headache and Celiac Disease: An Increasingly Investigated Association. Headache. 2016;56:1520-1521.
14. Lionetti E, Francavilla R, Maiuri L et al. Headache in pediatric patients with celiac disease and its prevalence as a diagnostic clue. J Pediatr Gastroenterol Nutr. 2009;49:202-7.
15. Ruggieri M, Incorpora G, Polizzi A, Parano E, Spina M, Pavone P. Low prevalence of neurologic and psychiatric manifestations in children with gluten sensitivity. J Pediatr. 2008;152:244-9.
16. Nenna R, Petrarca L, Verdecchia P, Florio M, Mastrogiorgio G, Bavastrelli M, Bonamico M, Cucchiara S. Celiac disease in a large cohort of children and adolescents with recurrent headache: a retrospective study. Dig Liver Dis. 2016;48:495-8.
17. Parisi P, Pietropaoli N, Ferretti A, Nenna R, Mastrogiorgio G, Del Pozzo M, Principessa L, Bonamico M, Villa MP. Role of the gluten-free diet on neurological-EEG findings and sleep disordered breathing in children with celiac disease. Seizure. 2015;25:181-3.
18. Assa A, Frenkel-Nir Y, Tzur D, Katz LH, Shamir R. Large population study shows that adolescents with celiac disease have an increased risk of multiple autoimmune and nonautoimmune comorbidities. Acta Paediatr. 2017;106:967-972.
19. Lahat et al. [Lahat, E., Broide, E., Leshem, M., Evans, S., and Scapa, E. Prevalence of celiac antibodies in children with neurologic disorders. Pediatr Neurol. 2000; 22: 393–396.
20. Inaloo S, Dehgahni SM, Farzadi F, Haghighat M, Imanieh MH. A comparative study of celiac disease in children with migraine headache and a normal control group. Turk J Gastroenterol. 2011;22:32-5.
21. Borgna-Pignatti C, Fiumana E, Milani M, Calacoci M, Soriani C. Celiac Disease in children with Migraine. Pediatrics. 2004;114: 1371.
22. Gabrielli, M.; Cremonini, F.; Fiore, G.; Addolorato, G.; Padalino, C.; Candelli, M.; Gasbarrini, A.; Pola, P. Gasbarrini, A. Association between migraine and Celiac disease: Results from a preliminary case-control and therapeutic study. Am. J. Gastroenterol. 2003; 98: 625–629.
23. Calvani M Jr, Parisi P, Guaitolini C, Parisi G, Paolone G. Latent coeliac disease in a child with epilepsy, cerebral calcifications, drug-induced systemic lupus erythematosus and intestinal folic acid malabsorption associated with impairment of folic acid transport across the blood brain barrier. Eur J Pediatr. 2001; 160: 288–292
24. Parisi P. The relationship between mucosal damage in celiac disease and the risk of neurological and psychiatric conditions is much more complex than previously thought. Eur J Neurol. 2018;25:797-798.

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