University of Worcester Worcester Research and Publications

A Gluten Free Diet in the Management of Epilepsy in People with Coeliac Disease or Gluten Sensitivity

Gilbey, Zoë and Bold, Justine (2020) A Gluten Free Diet in the Management of Epilepsy in People with Coeliac Disease or Gluten Sensitivity. Gastrointestinal Disorders, 2 (3). pp. 281-299. ISSN 2624-5647

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The aim of this review was to assess the effects of a gluten free diet (GFD) in the management of epilepsy in people with coeliac disease (CD) or gluten sensitivity (GS). A systematic approach was used to undertake a literature review. Five electronic databases (PubMed; Scopus; Google Scholar; Cochrane Epilepsy Group specialised register; Cochrane Register of Controlled Trails (CENTRAL) via the Cochrane Register of Online Trials) were searched using predetermined relevant search terms. In total, 668 articles were identified. Duplicates were removed and predefined inclusion and exclusion criteria were applied, and a PRISMA flow chart was produced. Data was extracted using Covidence software. Twelve studies on Epilepsy and CD involving a total of 70 participants were selected for analysis; narrative synthesis was used owing to the small sample sizes in the selected studies. None of the 12 studies meeting inclusion criteria investigated gluten sensitivity and epilepsy. All the included studies support a link between epilepsy and CD. GFD was effective in 44 out of 70 participants across the studies in terms of a reduction of seizures, reduction of antiepileptic drugs (AEDs) or normalisation of EEG pattern. A total of 44 participants showed a reduction in seizures (across eight studies) and complete cessation of seizures was reported in 22 participants. In general, the earlier the GFD is implemented after the onset of seizures, the better the likelihood of the GFD being successful in supporting control of seizures. Mechanisms linking gluten with epilepsy are not fully understood; possible hypotheses include gluten mediated toxicity, immune-induced cortical damage and malabsorption. Evidence suggests the effectiveness of a GFD in supporting the management of epilepsy in patients with CD, although the quality of evidence is low. There appears to be a growing number of neurologists who are prepared to advocate the use of a GFD. A multidisciplinary approaches and further research are recommended. It could be argued that when balancing potential treatments such as AEDs or surgery, a GFD has a low likelihood of harm.

Item Type: Article
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The full-text of the online published article can be accessed via the official URL. This article is included in the journal special issue, 'Coeliac Disease'.

© 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (

Uncontrolled Discrete Keywords: epilepsy, seizures, ketogenic diet, gluten free diet, coeliac disease, non-coeliac gluten sensitivity, gluten ataxia
Subjects: R Medicine > R Medicine (General)
Divisions: College of Health, Life and Environmental Sciences > School of Allied Health and Community
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Copyright Info: Open access article
Depositing User: Justine Bold
Date Deposited: 09 Sep 2020 13:51
Last Modified: 07 Dec 2020 17:13

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