Editing Ataxia (section)

=== Gluten ataxia ===
[[File:Gluten ataxia eng.ogg|thumb|A male with gluten ataxia: previous situation and evolution after three months of a gluten-free diet]]
Gluten ataxia is an [[autoimmune disease]] derived from [[celiac disease]],<ref>{{cite journal | vauthors = Giuffrè M, Gazzin S, Zoratti C, Llido JP, Lanza G, Tiribelli C, Moretti R | title = Celiac Disease and Neurological Manifestations: From Gluten to Neuroinflammation | journal = International Journal of Molecular Sciences | volume = 23 | issue = 24 | pages = 15564 | date = December 2022 | pmid = 36555205 | pmc = 9779232 | doi = 10.3390/ijms232415564 |doi-access=free}}</ref> which is triggered by the ingestion of [[gluten]].<ref name="MitomaAdhikari2016">{{cite journal | vauthors = Mitoma H, Adhikari K, Aeschlimann D, Chattopadhyay P, Hadjivassiliou M, Hampe CS, Honnorat J, Joubert B, Kakei S, Lee J, Manto M, Matsunaga A, Mizusawa H, Nanri K, Shanmugarajah P, Yoneda M, Yuki N | title = Consensus Paper: Neuroimmune Mechanisms of Cerebellar Ataxias | journal = Cerebellum | volume = 15 | issue = 2 | pages = 213–232 | date = April 2016 | pmid = 25823827 | pmc = 4591117 | doi = 10.1007/s12311-015-0664-x | type = Review }}</ref><ref name="sapone-etal-2010-b">{{cite journal | vauthors = Sapone A, Bai JC, Ciacci C, Dolinsek J, Green PH, Hadjivassiliou M, Kaukinen K, Rostami K, Sanders DS, Schumann M, Ullrich R, Villalta D, Volta U, Catassi C, Fasano A | title = Spectrum of gluten-related disorders: consensus on new nomenclature and classification | journal = BMC Medicine | volume = 10 | pages = 13 | date = February 2012 | pmid = 22313950 | pmc = 3292448 | doi = 10.1186/1741-7015-10-13 | doi-access = free | type = Review }}</ref> Early diagnosis and treatment with a [[gluten-free diet]] can improve ataxia and prevent its progression. The effectiveness of the treatment depends on the elapsed time from the onset of the ataxia until diagnosis, because the death of [[Purkinje cells|neurons in the cerebellum]] as a result of gluten exposure is irreversible.<ref name="MitomaAdhikari2016" /><ref name="HadjivassiliouSanders2015" /> It accounts for 40% of ataxias of unknown origin and 15% of all ataxias.<ref name="HadjivassiliouSanders2015">{{cite journal | vauthors = Hadjivassiliou M, Sanders DD, Aeschlimann DP | title = Gluten-related disorders: gluten ataxia | journal = Digestive Diseases | volume = 33 | issue = 2 | pages = 264–268 | year = 2015 | pmid = 25925933 | doi = 10.1159/000369509 | type = Review | s2cid = 207673823 }}</ref> Less than 10% of people with gluten ataxia present any gastrointestinal symptom and only about 40% have intestinal damage.<ref name="MitomaAdhikari2016" /><ref name="HadjivassiliouSanders2015" /> This entity is classified into primary auto-immune cerebellar ataxias (PACA).<ref>{{cite journal | vauthors = Hadjivassiliou M, Graus F, Honnorat J, Jarius S, Titulaer M, Manto M, Hoggard N, Sarrigiannis P, Mitoma H | title = Diagnostic Criteria for Primary Autoimmune Cerebellar Ataxia-Guidelines from an International Task Force on Immune-Mediated Cerebellar Ataxias | journal = Cerebellum | volume = 19 | issue = 4 | pages = 605–610 | date = August 2020 | pmid = 32328884 | pmc = 7351847 | doi = 10.1007/s12311-020-01132-8 }}</ref> There is a continuum between presymptomatic ataxia and immune ataxias with clinical deficits.<ref>{{cite journal | vauthors = Manto M, Mitoma H | title = Immune Ataxias: The Continuum of Latent Ataxia, Primary Ataxia and Clinical Ataxia | journal = Journal of Integrative Neuroscience | volume = 23 | issue = 79 | date = April 2024 | page = 79 | doi = 10.31083/j.jin2304079 | doi-access = free | pmid = 38682229 }}</ref>