What did this study look at?
Gluten ataxia is a neurological condition linked to gluten sensitivity, where the immune system mistakenly attacks part of the brain called the cerebellum, which is involved in balance and coordination. There is growing recognition of Gluten ataxia in adults, but much less is known about how it affects children and adolescents. Reports suggest that in 60%-70% of children with ataxia a cause is not found, and testing for sensitivity to gluten is not done routinely for children with ataxia.
The study, led by Dr Santosh Mordekar, looked at the clinical records of 20 children and adolescents, aged 6 to 15, who were seen at the Sheffield specialist paediatric ataxia centre with suspected gluten sensitivity over a five-year period. All had motor coordination or balance difficulties, and doctors investigated whether gluten sensitivity could be contributing to their symptoms. Half of the 20 children and adolescents had a first-degree family member with gluten sensitivity, Coeliac disease or Gluten ataxia. A quarter of the 20 children and adolescents had a diagnosis of Coeliac disease.
Which symptoms were identified?
All 20 children and adolescents showed difficulties with coordination and/or balance. Other common symptoms included headaches, dizziness on standing, sensory symptoms such as pins and needles or pain, fatigue, and changes in fine motor skills such as handwriting.
How was gluten sensitivity identified?
Blood tests showed that all 20 children had at least one antibody associated with gluten sensitivity. Antibodies are proteins in the immune system, which can indicate what the immune system will react to. In these children, the antibodies detected suggested their immune system could react to gluten. These included antibodies linked to Coeliac disease, as well as antigliadin and transglutaminase-6 (TG-6) antibodies. TG-6 antibodies may be more relevant to neurological forms of gluten sensitivity, including Gluten ataxia. Brain scans were usually structurally normal, but a specialist scan called MR spectroscopy showed changes in the cerebellum in many of the children.
Treatment with a gluten-free diet
18 of the children and adolescents were advised to follow a gluten-free diet. 13 of these reported improvements in symptoms such as balance, headaches, pain, fatigue, or concentration. Some also showed improvement in clinical ataxia scores or follow-up brain scans.
Why are these findings important?
The researchers suggest that gluten sensitivity should be considered in children with unexplained ataxia and motor coordination difficulties, even if they do not have Coeliac disease. Early recognition matters because Gluten ataxia may be a treatable cause of childhood ataxia. Larger studies and longer follow-up are now needed to understand how common Gluten ataxia is in children and adolescents, how best to diagnose it, and how children and adolescents respond to a gluten-free diet over time.
Read more about Gluten ataxia in our leaflet here.
