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Review

A Gluten Free Diet in the Management of Epilepsy in People with Coeliac Disease or Gluten Sensitivity

by 1 and 1,2,*
1
School of Allied Health & Community, University of Worcester, Worcester WR2 6AJ, UK
2
Centre for Medical Education, Medical School, Cardiff University, Cardiff CF14 4YS, UK
*
Author to whom correspondence should be addressed.
Gastrointest. Disord. 2020, 2(3), 281-299; https://0-doi-org.brum.beds.ac.uk/10.3390/gidisord2030026
Received: 2 August 2020 / Revised: 1 September 2020 / Accepted: 3 September 2020 / Published: 8 September 2020
(This article belongs to the Special Issue Coeliac Disease)
The aim of this review was to assess the effects of a gluten free diet (GFD) in the management of epilepsy in people with coeliac disease (CD) or gluten sensitivity (GS). A systematic approach was used to undertake a literature review. Five electronic databases (PubMed; Scopus; Google Scholar; Cochrane Epilepsy Group specialised register; Cochrane Register of Controlled Trails (CENTRAL) via the Cochrane Register of Online Trials) were searched using predetermined relevant search terms. In total, 668 articles were identified. Duplicates were removed and predefined inclusion and exclusion criteria were applied, and a PRISMA flow chart was produced. Data was extracted using Covidence software. Twelve studies on Epilepsy and CD involving a total of 70 participants were selected for analysis; narrative synthesis was used owing to the small sample sizes in the selected studies. None of the 12 studies meeting inclusion criteria investigated gluten sensitivity and epilepsy. All the included studies support a link between epilepsy and CD. GFD was effective in 44 out of 70 participants across the studies in terms of a reduction of seizures, reduction of antiepileptic drugs (AEDs) or normalisation of EEG pattern. A total of 44 participants showed a reduction in seizures (across eight studies) and complete cessation of seizures was reported in 22 participants. In general, the earlier the GFD is implemented after the onset of seizures, the better the likelihood of the GFD being successful in supporting control of seizures. Mechanisms linking gluten with epilepsy are not fully understood; possible hypotheses include gluten mediated toxicity, immune-induced cortical damage and malabsorption. Evidence suggests the effectiveness of a GFD in supporting the management of epilepsy in patients with CD, although the quality of evidence is low. There appears to be a growing number of neurologists who are prepared to advocate the use of a GFD. A multidisciplinary approaches and further research are recommended. It could be argued that when balancing potential treatments such as AEDs or surgery, a GFD has a low likelihood of harm. View Full-Text
Keywords: epilepsy; seizures; ketogenic diet; gluten free diet; coeliac disease; non-coeliac gluten sensitivity; gluten ataxia epilepsy; seizures; ketogenic diet; gluten free diet; coeliac disease; non-coeliac gluten sensitivity; gluten ataxia
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MDPI and ACS Style

Gilbey, Z.; Bold, J. A Gluten Free Diet in the Management of Epilepsy in People with Coeliac Disease or Gluten Sensitivity. Gastrointest. Disord. 2020, 2, 281-299. https://0-doi-org.brum.beds.ac.uk/10.3390/gidisord2030026

AMA Style

Gilbey Z, Bold J. A Gluten Free Diet in the Management of Epilepsy in People with Coeliac Disease or Gluten Sensitivity. Gastrointestinal Disorders. 2020; 2(3):281-299. https://0-doi-org.brum.beds.ac.uk/10.3390/gidisord2030026

Chicago/Turabian Style

Gilbey, Zoë, and Justine Bold. 2020. "A Gluten Free Diet in the Management of Epilepsy in People with Coeliac Disease or Gluten Sensitivity" Gastrointestinal Disorders 2, no. 3: 281-299. https://0-doi-org.brum.beds.ac.uk/10.3390/gidisord2030026

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