Magnetic resonance spectroscopic findings in neuro-Behçet disease

Behçet disease is a heterogeneous, multisystem disorder with elements of both environmental and autoimmune pathologic processes. Neuro-Behçet, found in 10%-25% of Behçet patients, has been characterized as a vasculitis primarily affecting the brain stem. On magnetic resonance imaging, some cases demonstrate extension to the bilateral cerebral cortices and/or the spinal cord, often with a degree of mass effect. Content of this paper provides a case study, along with review of the literature regarding this disease entity, and proceeds to outline the appearance of neuro-Behçet on magnetic resonance spectroscopy.

In essence, a drop in the N-acetyl aspartate peak indicative of axonal loss in concert with elevations in lipid myoinositol and choline/creatine ratios (nonspecific markers of myelin breakdown) is found, indicating that a possible demyelinating process is complexed with the vasculitic pathology neuro-Behçet is traditionally ascribed to.