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Epilepsy and other Neurological Disorders in Coelic Disease.
  1. MARK MANFORD

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    Epilepsy and other Neurological Disorders in Coelic Disease. Edited by g gobbi, f andermann, s naccarato, and g banchini. (Pp396, £65.00) Published by John Libbey Co, London, 1997. ISBN 0-86196-537-X.

    In Soho, there used to be a restaurant called Fatso’s. Here you could eat as many bowls of different pastas with creamy sauces as you could manage for a fixed price. I feel sure that I made a major contribution to its bankruptcy, quite soon after opening. Now, as well as the high fat intake I learn I have exposed myself to increased risk of epilepsy, cerebral calcifications, dementia, peripheral axonal neuropathy, schizophrenia, anxiety, and depression. For these are some conditions apparently associated with coeliac disease and the risk of coeliac disease seems to be greatest in those consuming large amounts of gluten in wheat products, especially pasta. The most interesting chapter tracks the evolution of human diet from hunter-gatherers to farmers, the growth of gluten as a foodstuff and relation to gluten intolerance in different populations, especially in association with the associated HLA-B8 genotype. There are some more general chapters early on discussing current concepts of gluten intolerance and pathogenesis of coeliac disease. The neurology of this area is only just being uncovered and the remainder of the book comprises short papers and case reports that introduce the possible range of the disease. The papers are illustrated by some good quality scans, and clinical and pathological photographs. The book should be seen as an introduction to a field and as a collection of papers it is inevitably fragmentary. Nevertheless, it is a shame that there is no attempt at a unifying chapter and it is difficult to take away any clear message from the book. It will prove useful to neurological libraries as a source to which to refer with comprehensive access to the literature. I came away hoping that at least I had drunk enough Chianti to counter the effects of the saturated fats.

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