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[Serial MRI findings in neuro-Behçet disease].

Y Yamashita1, Y Ikeda, H Tajima

  • 1Department of Neurosurgery, Nippon Medical School.

No Shinkei Geka. Neurological Surgery
|December 1, 1992
PubMed
Summary

This case study highlights neuro-Behçet disease, a neurological complication of Behçet disease. Prompt steroid treatment led to significant clinical improvement and reduced brain lesions in a patient presenting with TIA-like symptoms.

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Area of Science:

  • Neurology
  • Immunology
  • Radiology

Background:

  • Behçet disease is a systemic vasculitis characterized by oral ulcers, genital ulcers, and uveitis.
  • Neurological involvement (neuro-Behçet) affects 10-25% of patients, manifesting as diverse neurological deficits.
  • This report details a specific case of neuro-Behçet disease with transient ischemic attack (TIA) symptoms.

Observation:

  • A 51-year-old male presented with recurrent oral and genital ulcers, followed by TIA-like symptoms including cognitive decline, facial nerve palsy, and hemiparesis.
  • Cerebrospinal fluid (CSF) analysis revealed pleocytosis.
  • Brain imaging (CT and MRI) demonstrated multiple enhancing lesions in the cerebral hemispheres and brainstem, consistent with active neuroinflammation.

Findings:

  • The patient received high-dose steroid therapy, resulting in marked clinical improvement.
  • Post-treatment CSF analysis normalized, and repeat imaging showed reduced lesion size and enhancement.
  • MRI findings correlated well with the patient's clinical presentation and response to treatment.

Implications:

  • This case underscores the importance of recognizing neuro-Behçet disease in patients with characteristic systemic symptoms and neurological deficits.
  • Early diagnosis and aggressive immunosuppressive therapy, such as high-dose steroids, can lead to favorable outcomes.
  • Advanced neuroimaging plays a crucial role in diagnosing, monitoring, and assessing treatment response in neuro-Behçet disease.