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Recurrent peripheral facial paralysis (PFP) is an uncommon disorder that often occurs in the setting of family history. In 2001, we observed a patient with recurrent PFP who manifested symptoms of coeliac disease (CD) several months later. Because of this observation and because neurological disorders may be the only manifestation of atypical forms of CD,1 we started to screen for gluten-related diseases all patients with at least two episodes of PFP who were referred to our department between 2001 and 2011. We performed initial screening serological tests (antigliadin, antitransglutaminase and antiendomysial antibodies), followed by a confirmatory small intestinal biopsy in positive cases. Testing for human leucocyte antigen (HLA) class 2 alleles was performed in patients with uncertain diagnosis2 in that positive HLA-DQ2 or HLA-DQ8 genotypes are useful to support the diagnosis of potential CD in patients with positive serology and mild or absent histological lesions.3
The frequency of CD in PFP population was compared by Fisher exact test with that observed in a control group of 100 consecutive patients admitted to out-patient clinic for several neurological disorder including multiple sclerosis, cranial neuropathies not involving facial nerve and neuromuscular disorders.
We observed eight consecutive Caucasian …
Competing interests None.
Provenance and peer review Not commissioned; externally peer reviewed.
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