It's NOT all in my head

I came across a recent study done regarding celiac paitents and small-fiber neuropathies:

Celiac Disease Tied to Small-Fiber Neuropathies

By David Douglas

NEW YORK (Reuters Health) Oct 17 - Some patients with celiac disease have small-fiber neuropathy, according to a case series based on skin biopsies reported in the October issue of the Archives of Neurology.

"Painful small fiber neuropathies sometimes are caused by diabetes, but often no cause is found," lead investigator Dr. Thomas H. Brannagan told Reuters Health. "Celiac disease may be an important cause of small fiber neuropathy."

Dr. Brannagan of Weill Medical College of Cornell University, New York and colleagues report on findings in 8 such celiac disease patients.

Neuropathy began at points ranging from childhood to 59 years. All had asymmetric numbness or paresthesias. Three had more prominent involvement of the hands than feet, 3 had facial numbness, ankle reflexes were normal in 5 and diminished in 3.

Celiac disease was diagnosed in 5 of the patients after their neuropathy began. The others were referred for evaluation before the diagnosis.

In the 7 patients who underwent a glucose tolerance test, there was no sign of diabetes. Nerve conduction studies were normal in 7 patients and 1 had mildly reduced sural amplitudes. Epidermal nerve fiber density was reduced in 5 patients and was at the low limit of normal in the other 3.

One patient had no improvement with a gluten-free diet and symptoms developed in 2 while receiving a gluten-free diet. However, 4 responded and reported improvements while on a gluten-free diet.

Overall, the researchers observe that the findings point to a sensory ganglionopathy or an immune-mediated neuropathy.

Dr. Brannagan concluded that "celiac disease, which is now increasingly recognized in North America, is important to identify" and thus allow treatment by means of a gluten-free diet.

Arch Neurol 2005;62:1574-1578.