CONCLUSIONS: Neuropsychiatric manifestations are clinically significant yet frequently underrecognized components of CeD. In some patients, they are directly evoked by gluten exposure; in others, gluten acts as a trigger of self-perpetuating neuroimmune or neuroinflammatory cascades. Early identification, multidisciplinary management, and strict dietary monitoring are essential to prevent irreversible neurological damage and optimize long-term outcomes.
