Two adult case reports of improved neurological status with the removal of gluten from diet

Posted on December 3, 2012 by Maurice Preter MD

Two adult case reports of improved neurological status with the removal of gluten from diet

Author: Sue Wood Co-author Beth Zupec-Kania
1.Dietitian, Matthews Friends Clinics 2.Nutrition Consultant

Key words: 1. Gluten-free 2. Gluten sensitivity 3. Epilepsy 4. Neurological dysfunction

Introduction: Gluten sensitivity is a systemic autoimmune or immune mediated disease with diverse manifestations 1. Coeliac disease (CD) is the most commonly recognized of these and estimated to occur in at least 1% of the population. There has been conflicting data provided by studies of the association between epilepsy and coeliac disease. However, a recent review concluded with the recommendation that routine screening for CD be performed on all patients with intractable epilepsy, particularly those with temporal lobe epilepsy and hippocampal sclerosis2, 3.
We present two adult cases of intractable epilepsy where gluten exclusion has led to an improvement in seizures and/ or neurological symptoms. Ketogenic diet regimes are readily gluten free and this may carry more significance, particularly in the management of adult cases of intractable epilepsy, than previously thought.

Case 1: A 62 year old female with a long standing history of gastro-intestinal disturbance and a 7 year history of intractable temporal lobe epilepsy with hippocampal sclerosis (negative TTG and jejunal biopsy) was started on a strict gluten free diet trial prior to consideration of ketogenic therapy. Within three months, the absence seizures resolved and this has now been maintained for sixteen months. Infrequent seizure incidences have been traced back to accidental exposure to gluten and generally occur within one to two hours of eating.

Case 2: A 47 year old female with medication resistant epilepsy was initiated on a modified ketogenic diet restricted to 30 grams of carbohydrate daily resulting in strong ketosis. Her tonic-clonic seizures reduced to greater than 50% after 3 months and she was able to return to activities of daily living. In attempts to improve the selection of carbohydrate in her diet, gluten-containing foods were removed (breads and cereals) and were replaced with equivalent carbohydrate from vegetables. Her husband noticed a dramatic improvement in her cognition and balance however no change in seizure-control. The gluten-free diet restriction was maintained due to these neurological benefits.

1. Hippocampal sclerosis in refractory temporal lobe epilepsy is associated with gluten sensitivity J Neurol Neurosurg Psychiatry 2009 80: 626-630.
M Peltola, K Kaukinen, P Dastidar, et al.
2.Gluten sensitivity: from gut to brain Lancet Neurol 2010; 9: 318–30

M Hadjivassiliou, D Sanders, R Grünewald, et al.

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The effect and Long-term retention rate of ketogenic diet in Chinese patients.

Posted on December 3, 2012 by Maurice Preter MD

The effect and Long-term retention rate of ketogenic diet in Chinese patients

Author: DENG Yu Hong
Co-authors ZHOU Jin-Hua, LI Bing-Mei, LIU Xiao-Rong, LIAO Wei-Ping

Changgang Dong road 250, haiZhu, Guangzhou, GuangDong, P.R China,510260

Keyword 1 ketogenic diet Keyword 2 refractory epilepsy Keyword 3 effect
Keyword 4 retention rate

Objective: To evaluate the effect and long-term retention of ketogenic diet (KD) in add-on therapy for refractory epilepsy patients with Chinese eating habits.

Methods: 28 Chinese patients with refractory epilepsy were recruited in one and half a year. In the first three months, there were no changes of the anti-epilepsy drug. All patients were hospitalized and started with fat / (protein + carbohydrates) = 4:1 diet, then maintained the 4:1 diet after discharged. According to the recruiting day, the follow-up period persist from 3 months to 12 months. The retention rate, the efficacy and the incidence of side effects on specific follow-up time point were observed.

Results: On the third month, 68% of patients reduced >50% seizures, 43% (12/28) of patients reduced >90% seizures, 11% were seizure-free. The retention rate was 68% (19/28) at the third month, while it was 43% (10/23) at the sixth month and 28% (5 /18) at the twelfth year. The major side effect s in the first two weeks included gastrointestinal reactions, ketoacidosis and low glucose; the major side effects in the persistence period were constipation, hyperlipidemia, and hypoalbuminemia. Only one patient withdrew the diet due to side effects.

Conclusions: KD in Chinese refractory epilepsy patients is highly effective, but the long-term retention rate is low probably related to the Chinese eating habits. Better implementation needs to be further studied.

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Olive (Olea europaea L.) leaf extract elicits antinociceptive activity, potentiates morphine analgesia and suppresses morphine hyperalgesia in rats

Posted on November 25, 2012 by Maurice Preter MD

J Ethnopharmacol. 2010 Oct 28;132(1):200-5. Epub 2010 Aug 14.

Olive (Olea europaea L.) leaf extract elicits antinociceptive activity, potentiates morphine analgesia and suppresses morphine hyperalgesia in rats.

Esmaeili-Mahani S, Rezaeezadeh-Roukerd M, Esmaeilpour K, Abbasnejad M, Rasoulian B, Sheibani V, Kaeidi A, Hajializadeh Z.

Source

Department of Biology, Faculty of Sciences, Shahid Bahonar University of Kerman, Kerman, Iran. semahani@yahoo.com

Abstract

AIM OF THE STUDY:

Olive (Olea europaea) leaves are used as anti-rheumatic, anti-inflammatory, antinociceptive, antipyretic, vasodilatory, hypotensive, antidiuretic and hypoglycemic agents in traditional medicine. Recently, it has been shown that olive leaf extract (OLE) has calcium channel blocker property; however, its influences on nociceptive threshold and morphine effects have not yet been clarified.

MATERIALS AND METHODS:

All experiments were carried out on male Wistar rats. The tail-flick, hot-plate and formalin tests were used to assess the effect of OLE on nociceptive threshold. To determine the effect of OLE on analgesic and hyperalgesic effects of morphine, OLE (6, 12 and 25 mg/kg i.p.) that had no significant nociceptive effect, was injected concomitant with morphine (5 mg/kg and 1 μg/kg i.p., respectively). The tail-flick test was used to assess the effect of OLE on anti- and pro-nociceptive effects of morphine.

RESULTS:

The data showed that OLE (50-200 mg/kg i.p.) could produce dose-dependent analgesic effect on tail-flick and hot-plate tests. Administration of 200 mg/kg OLE (i.p.) caused significant decrease in pain responses in the first and the second phases of formalin test. In addition, OLE could potentiate the antinociceptive effect of 5 mg/kg morphine and block low-dose morphine-induced hyperalgesia.

CONCLUSION:

Our results indicate that olive leaf extract has analgesic property in several models of pain and useful influence on morphine analgesia in rats. Therefore, it can be used for the treatment and/or management of painful conditions.

Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

via Olive (Olea europaea L.) leaf extract elici… [J Ethnopharmacol. 2010] – PubMed – NCBI.

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Daily social interactions that are negative and competitive are associated prospectively with heightened proinflammatory cytokine activity.

Posted on November 25, 2012 by Maurice Preter MD

Proc Natl Acad Sci U S A. 2012 Feb 7;109(6):1878-82. Epub 2012 Jan 23.

Negative and competitive social interactions are related to heightened proinflammatory cytokine activity.

Chiang JJ, Eisenberger NI, Seeman TE, Taylor SE.

Source

Department of Psychology, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA.

Abstract

Research has consistently documented that social relationships influence physical health, a link that may implicate systemic inflammation. We examined whether daily social interactions predict levels of proinflammatory cytokines IL-6 and the soluble receptor for tumor necrosis factor-α (sTNFαRII) and their reactivity to a social stressor. One-hundred twenty-two healthy young adults completed daily diaries for 8 d that assessed positive, negative, and competitive social interactions. Participants then engaged in laboratory stress challenges, and IL-6 and sTNFαRII were collected at baseline and at 25- and 80-min poststressor, from oral mucosal transudate. Negative social interactions predicted elevated sTNFαRII at baseline, and IL-6 and sTNFαRII 25-min poststressor, as well as total output of sTNFαRII. Competitive social interactions predicted elevated baseline levels of IL-6 and sTNFαRII and total output of both cytokines. These findings suggest that daily social interactions that are negative and competitive are associated prospectively with heightened proinflammatory cytokine activity.

PMID:

22308464

[PubMed – indexed for MEDLINE]

PMCID:

PMC3277534

Free PMC Article

via 18 selected items – PubMed – NCBI.

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Social pain–the painful feelings associated with social disconnection–rely on some of the same neurobiological substrates that underlie experiences of physical pain

Posted on November 25, 2012 by Maurice Preter MD

Nat Rev Neurosci. 2012 May 3;13(6):421-34. doi: 10.1038/nrn3231.

The pain of social disconnection: examining the shared neural underpinnings of physical and social pain.

Eisenberger NI.

Source

University of California, Department of Psychology, 4444 Franz Hall, Los Angeles, California 90095, USA. neisenbe@ucla.edu

Abstract

Experiences of social rejection, exclusion or loss are generally considered to be some of the most ‘painful’ experiences that we endure. Indeed, many of us go to great lengths to avoid situations that may engender these experiences (such as public speaking). Why is it that these negative social experiences have such a profound effect on our emotional well-being? Emerging evidence suggests that experiences of social pain–the painful feelings associated with social disconnection–rely on some of the same neurobiological substrates that underlie experiences of physical pain. Understanding the ways in which physical and social pain overlap may provide new insights into the surprising relationship between these two types of experiences.

PMID:

22551663

[PubMed – indexed for MEDLINE]

Related citations

via 18 selected items – PubMed – NCBI.

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