[Serial MRI findings in neuro-Behçet disease]

Behçet disease is a systemic disorder characterised by the triad of recurrent aphthous ulcers of the mouth, genital ulcers and uveitis. Neurological involvement is estimated at 10-25% in Behçet disease (neuro-Behçet). These include diplopia, pseudobulbar palsy, cranial nerve palsies, cerebeller ataxia, and cerebral and spinal sensory and motor disturbances. A case of neuro-Behçet disease is reported. A 51-year-old man was admitted with TIA attack. He had been suffering from recurrent oral and genital ulcers for several months before admission. Neurological examination on admission revealed poor mental activity, left facial nerve palsy and left hemiparesis. Lumbar puncture showed CSF pleocytosis. CT and MRI revealed multiple lesions in the cerebral hemisphere and the brain stem. CT showed spotty high density areas with perifocal low density areas in the frontal, temporal and parietal lobe which were enhanced with contrast materials. T1 weighted image of MRI revealed iso intensity areas with perifocal low intensity areas which were enhanced with Gd-DTPA in the frontal, temporal and parietal lobes. T2 weighted image revealed low intensity areas with perifocal high intensity areas in the same regions shown in the T1 weighted image. Moreover ring-like enhanced lesions with Gd-DTPA were revealed in the brain stem and corona radiata in the T1 weighted image. After high dose steroid treatment, he showed marked clinical improvement. CSF pleocytosis was normalized and the lesions were gradually reduced in size and were no longer enhanced with Gd-DTPA. MRI findings are well correlated with clinical features.(ABSTRACT TRUNCATED AT 250 WORDS)