Bilateral Occipital
Calcifications, Epilepsy and Coeliac Disease
Kolníková M., Sýkora P., Szabová I., Krajčírová M. 1 , Brozmanová M.
Neurologické oddelenie, DFNsP, Bratislava 1 II. Detská klinika LF UK, DFNsP, Bratislava |
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Summary:
Coeliac disease – gluten enteropathy – is a chronic nutritional disorder frequently associated with
neurological symptoms. It may present as neuromuscular disease with neuropathy and m yositis, there
can be epileptic attacks with cerebral calcifications or progressive encephalopathy with ataxia and
epilepsy. The authors describe the case-history of a 18-year-old boy with coeliac disease, pharmacore-
sistent epilepsy and bilateral occipital calcifications. In the case-history are data on psychomotor
retardation, repeated febrile attacks from the age of 9 months. Afebrile attacks started at the age of 4
years by atypical absences, at the age of 9 years dominate myoclonic-astatic attacks with falls and at
the age of 10 years there are moreover generalized tonic-clonic and tonic attacks. The attacks occur
daily and are pharmacoresistent. In the objective finding there was advancing mental deficiency with
mild cerebellar symptomatology. On the EEG there was always a disorder of the basic activity,
generalized discharges of complexes of the spike and wave with 2–2.5 c/s frequency and enhanced
rhytms during sleep. The clinical form of attacks and EEG corresponded with the Lennox-Gastaut
syndrome. In the CT picture from the age of 9 years cortico-subcortical bilateral occipital but also
parietal and frontal calcifications were present which do not change after administration of contrast
substance. Results of angiographic examination were normal, in the MR examination are non-specific
bilateral occipital changes. Enterobiopsy confirmed chronic enteritis with villous atrophy. The authors
draw attention to the possibility that coeliac disease caused pharmacoresistent epilepsy with the
finding of bilateral occipital calcifications.
Key words:
coeliac disease, occipital calcifications, pharmacoresistent epilepsy, Lennox-Gastaut syn-
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