Neurological Sciences

, Volume 32, Issue 5, pp 911–914

Downbeat nystagmus, ataxia and spastic tetraparesis due to coeliac disease

  • Mario Habek
  • Iva Hojsak
  • Barbara Barun
  • Vesna V. Brinar
Case Report


A 25-year-old female presented to a university neurology clinic with a 1-month history of progressive ataxia, downbeat nystagmus and spastic tetraparesis. Personal history revealed polyarthralgias and weight loss. Family history was negative. Following thorough history, laboratory, neurophysiological and MRI investigations, a diagnosis of cerebellar ataxia due to coeliac disease was done. The patient was treated with strict gluten-free diet and intravenous administration of immunoglobulins. Although there are many controversies about neurological manifestations of coeliac disease, this case pointed to strong association between these two disorders. The findings of elevated protein content in the cerebrospinal fluid with positive oligoclonal bands suggested an immune-mediated process, further supported by positive anti-endomysium antibodies and anti-transglutaminase antibodies in the cerebrospinal fluid.


Ataxia Coeliac disease Immunoglobulin A anti-endomysium antibodies Immunoglobulin A anti-transglutaminase antibodies Cerebrospinal fluid 

Supplementary material

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Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Mario Habek
    • 1
    • 2
  • Iva Hojsak
    • 3
    • 4
  • Barbara Barun
    • 1
    • 2
  • Vesna V. Brinar
    • 1
    • 2
  1. 1.Department of NeurologySchool of Medicine, University of ZagrebZagrebCroatia
  2. 2.University Department of Neurology, Refferal Center for Demyelinating Diseases of the Central Nervous SystemSchool of Medicine and University Hospital Center ZagrebZagrebCroatia
  3. 3.Department of Pediatrics, Referral Center for Pediatric Gastroenterology and NutritionChildren’s Hospital ZagrebZagrebCroatia
  4. 4.Referral Center for Pediatric Gastroenterology and NutritionChildren’s Hospital Zagreb, University Hospital Center “Sestre milosrdnie”ZagrebCroatia

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