All about gluten ataxia

Ataxia is the medical word for a lack of muscle control or the ability to coordinate voluntary movements. Ataxia is a sign of an underlying condition and it can create difficulty with walking, coordination, speech, eye movement and swallowing. 

Ataxia occurs when the part of the brain that controls muscle coordination, the cerebellum, is damaged. Many different conditions can cause ataxia, such as a stroke, alcohol abuse, certain medications, cerebral palsy, a tumour, multiple sclerosis and other autoimmune disorders including coeliac disease.  

Gluten ataxia is an autoimmune disorder in which the antibodies in a person with coeliac disease or another kind of gluten sensitivity direct their attack at the cerebellum, affecting the central nervous system. Gluten ataxia is still not fully understood or even universally recognised across the medical community. 

How common is gluten ataxia? 

It is also unclear how common it is. One group of researchers concluded that gluten sensitivity was the largest single cause of ataxia in cases where the problem is not linked to a diagnosed condition such as cerebral palsy. Other studies say that gluten ataxia could be a factor in around 23% of patients with unexplained ataxia.   

Much remains to be discovered about the causes and risk factors relating to gluten ataxia. The research that has been done links the disorder to coeliac disease and finds a prevalence of the same genetic variant that the majority of coeliac patients also have. Coeliac disease occurs almost exclusively in people with certain variants of the Human Leukocyte Antigen (HLA) genes, although other environmental factors are believed to play a part in the development of the disease.  

There is also some evidence that people who suffer from gluten ataxia will also develop signs of cerebellar atrophy, which is a shrinkage of the cerebellum.  

Gluten ataxia is a progressive condition with neurological symptoms. This means that symptoms may start being mild and gradually progress to become severely debilitating. The symptoms can be the same as with other ataxia conditions, meaning getting an accurate diagnosis can be extremely difficult. Among the more typical symptoms that might be experienced with gluten ataxia are:  

• Problems with normal movements, such as walking or arm control 

• Unsteadiness, a loss of balance 

• Coordination problems 

• Loss of precision skills, such as the ability to button a shirt or write 

• Difficulty talking 

• Deteriorated vision 

• Symptoms of nerve damage in the hands, feet and limbs 

Although gluten ataxia is related to gluten sensitivity, digestive symptoms are not necessarily present. 

Because the disease is progressive, the symptoms will change over time. It is common for the first signs of gluten ataxia to manifest themselves in trouble with walking, meaning the person is more likely to trip and stumble, or develop an abnormal way of walking. With time, other issues might occur, such as dizziness, loss of balance, speech issues and finer motor skills for precise tasks.  

The condition can be improved early on by switching to a gluten free diet, but the longer it goes on undiagnosed, the more likely the symptoms are to become permanent. The most accepted diagnosis for gluten ataxia is by running the tests for coeliac disease.  

As of today, gluten ataxia can be treated only by the removal of all gluten from the person’s diet. Even tiny traces of gluten can allow the disease to continue its progression, so it is vital to be strict and extremely careful about sourcing reliably gluten free food and avoiding possibilities of accidental cross-contamination.  

Research has shown that patients with gluten ataxia can eliminate anti-gliadin antibodies from their systems if they adhere to a gluten free diet. Some scientists continue to be sceptical about the original connection between gluten antibodies and ataxia, however. Much more still needs to be discovered about the condition of gluten ataxia.