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Adult celiac disease presenting as cerebellar syndrome

Neurology Service, Providence Veterans Administration Medical Center, the Subsection of Neurology, Division of Biological and Medical Sciences, Brown University (Drs. Finelli and McEntee), Providence, RI, and the Departments of Pathology (Dr. Ambler) and Gastroenterology (Dr. Kestenbaum), Rhode Island Hospital. Providence.

A progressive pancerebellar syndrome in a 57-year-old man heralded what was subsequently diagnosed by malabsorption studies and jejunal biopsy as adult celiac disease. Postmortem examination demonstrated characteristic gastrointestinal and cerebral abnormalities associated with this enteropathy. The neuropathology underlying the ataxia, as well as the clinical features of palatal myoclonus and marked speech impairment, included marked cerebellar cortical atrophy with cell loss in dentate and olivary nuclei. Intestinal-absorption studies are indicated to evaluate patients with any neurologic illness that may be related to malabsorption.

Address correspondence and reprint requests to Dr. Finelli, Veterans Administration Medical Center, Davis Park, Providence, RI 02908.

Accepted for publication August 10, 1979.

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