Epileptic seizures in Behçet disease

To outline the clinical characteristics of seizures in our large series of Behçet disease (BD) patients with neurologic involvement.

All files of 223 patients with neuro-BD were evaluated retrospectively, and the group with clearly documented seizures was included in the current study. Clinical characteristics, EEG, neuroimaging and cerebrospinal fluid findings were reevaluated, and the seizures were classified according to the new proposed criteria of the International League Against Epilepsy. On excluding the patients in whom the seizures were due to possible seizure-provoking factors, the seizures that appeared during a neurologic exacerbation were noted.

Seizures were seen in 10 (4.48%) of 223 patients. There were one female and nine male patients. In five of the patients, seizures occurred during neurologic exacerbation. Therefore, the actual prevalence of seizures due to BD in our group is 2.2%. In the remaining five patients, the seizures were not related to neurologic BD attacks, but probably were due to some seizure-provoking factors. The predominating seizure type was generalized tonic-clonic convulsions accompanied by focal motor seizures. It is notable that four patients died 1-5 years after the onset of the seizures.

Our study showed that seizures are rare in BD. As the seizures due to some interventions and drugs are as frequent as neuro-BD-related seizures, seizure-provoking factors must be considered before attributing them to the pathogenetic mechanism of BD. The occurrence of seizures seems to be associated with a high mortality rate.