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Case Report

A 70-year-old male with peripheral neuropathy, ataxia and antigliadin antibodies shows improvement in neuropathy, but not ataxia, after intravenous immunoglobulin and gluten-free diet

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Pages 93-96 | Published online: 09 Oct 2008

Figures & data

Table 1 Quantitative measures of peripheral sensory threshold indices and autonomic function done at the time of presentation and after 17 months of treatment. Measures of peripheral neuropathy are vibration and pressure sensations, warm and cold perceptions and painful perception (CitationVinik et al 1995). The E/I (exipiratory/inspiratory ratio), 30:15 stand test and valsalva are measures of autonomic nerve function (CitationVinik and Erbas 2001)

Figure 1 This figure represents the progressive changes in central and peripheral nervous system scores. The central nervous system (CNS) signs score is the sum of the number of positive cerebellar signs. The total peripheral neuropathy impairment scores and sensory scores were obtained from our clinical evaluation scoring system (CitationVinik et al 2005b) modified from the Rochester Diabetic Neuropathy Study (CitationDyck et al 1992). In this system a score of 1 or 0 is given for the presence or absence of neuropathy symptom respectively. Motor, sensory and autonomic nervous systems are evaluated and given scores on a scale of 0 to 4, 0 being no impairment and 4 being severe impairment. Antioxidant treatment instituted at point A, IV Ig infusion instituted at point B and Point C is when gluten free diet was started.

Figure 1 This figure represents the progressive changes in central and peripheral nervous system scores. The central nervous system (CNS) signs score is the sum of the number of positive cerebellar signs. The total peripheral neuropathy impairment scores and sensory scores were obtained from our clinical evaluation scoring system (CitationVinik et al 2005b) modified from the Rochester Diabetic Neuropathy Study (CitationDyck et al 1992). In this system a score of 1 or 0 is given for the presence or absence of neuropathy symptom respectively. Motor, sensory and autonomic nervous systems are evaluated and given scores on a scale of 0 to 4, 0 being no impairment and 4 being severe impairment. Antioxidant treatment instituted at point A, IV Ig infusion instituted at point B and Point C is when gluten free diet was started.