Background:
In addition to gastrointestinal manifestations, several neurological complications have been reported in the celiac disease (CD) including epilepsy. However, the reported prevalence of epilepsy among patients with celiac disease varies substantially across studies. We conducted a systematic review and meta-analysis to estimate the pooled prevalence of epilepsy in individuals with celiac disease.
Methods:
A systematic search of PubMed, Embase, and Scopus was performed from database inception through March 2026. Observational studies reporting the prevalence of epilepsy among patients with confirmed celiac disease were included. A random-effects meta-analysis was conducted to calculate pooled prevalence estimates with corresponding 95% confidence intervals (CIs). Heterogeneity was assessed using the I² statistic.
Results
Nine studies comprising 68,907 patients with celiac disease were included in the analysis. Individual study prevalence estimates ranged from 0% to 5%. The pooled prevalence of epilepsy among patients with celiac disease was 1% (95% CI: 1%–2%). Significant between-study heterogeneity was observed (I² = 76.7%, p < 0.001). Importantly, the pooled prevalence was approximately twice the estimated global prevalence of epilepsy in the general population (≈0.5%), suggesting a meaningful epidemiological association between celiac disease and epilepsy. Despite heterogeneity, the majority of included studies reported a higher burden of epilepsy among patients with celiac disease than would be expected in the general population.
Conclusions
This meta-analysis demonstrates that epilepsy affects approximately 1 in 100 patients with celiac disease, representing nearly a twofold higher prevalence than that observed globally in the general population. These findings reinforce the growing evidence linking celiac disease and neurological disorders and underscore the importance of considering celiac disease in the evaluation of patients with epilepsy, particularly those with unexplained seizures or accompanying gastrointestinal symptoms. Further prospective studies are warranted to clarify the mechanisms underlying this association and to determine the impact of gluten-free dietary interventions on seizure control.