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Multiple sclerosis (MS) and coeliac disease (CD) are an uncommon association. Recently "MS-like illness and CNS white-matter abnormalities" have been demonstrated in patients with CD. We report the case of a 19-year-old female with MS, who presented an episode of headache at onset of disease and developed acute hepatitis (AH) 14 months later. After the diagnosis of AH, an occult CD, confirmed by jejunal biopsy, was disclosed. Constipation was the only gastrointestinal symptom. A serum sample collected before onset of MS was positive for CD. Anti-central nervous system antibodies were negative in both retrospective and current serum samples. Conclusions The concomitant presence of MS with atypical onset, AH and CD likely represents an unusual chance association in our patient but inflammatory immune-mediated damage of the central nervous system triggered by gluten could not be excluded.

A double-blind clinical trial of vincamine hydrochloride and a known dihydrogenated ergotoxine derivative, administered i.m. for 10 days, was conducted on 2 groups of 10 hospitalised cerebrovascular patients. Hemiplegia was evaluated prior to treatment and on its 5th and 10th day, by a scoring system. Statistical assessment of the results and the clinical observations showed that vincamine hydrochloride can be usefully employed in the treatment of acute cerebrovascular accidents on account of its marked effectiveness and rapid action--these being attributable to its cerebral vasoregulatory and metabolic mechanism, and to increased availability due to salification of the basic molecule--, coupled with its excellent local and general tolerability.