Cerebellar ataxia associated with subclinical celiac disease responding to gluten-free diet

Abstract
A 34-year-old man was first observed in June 1994 with a 7-year history of slowly progressive ataxia. Neurologic examination revealed wide-based gait, positive Romberg’s sign, horizontal nystagmus on lateral gaze, mild dysarthria, dysmetria in right upper limb and lower limbs, and brisk reflexes in lower limbs with mild spasticity. Results of sensory examination and muscle strength were normal. Plantar responses were flexor. The patient’s score on the Inherited Ataxias Clinical Rating Scale (IACRS)3 was 10. Brain MRI showed vermian atrophy. Neurophysiologic data are summarized …