Neurologic soft signs in Behcet disease

Patients with Behcet disease have an excess of minor neurologic abnormalities (neurologic soft signs).

(a) To investigate the neurologic soft signs (NSS) in Behcet disease (BD) patients who had no neurologic symptoms, by using the neurologic evaluation scale (NES). (b) To evaluate the effect of silent infarction on NES scores in BD patients.

Thirty six BD patients without neurologic symptoms and 36 healthy controls were included in the study. NSS were assessed with the NES. Cranial magnetic resonance imaging was conducted to determine the presence of silent cerebral infarcts.

Patients with BD had significantly higher scores overall and on each subscale (except for subscale "others") of the NES than the control group's. Tandem walk, adventitious overflow, tremor, graphesthesia, fist edge palm test, Ozeretski test, finger thumb opposition, mirror movements, extinction, synkinesis, convergence, finger nose test, glabellar reflex, grasp reflex, and suck reflex were also significantly higher in patients with BD than in the healthy control group. There were no significant differences in the total NES scores, total subscale scores and each of the NES items between BD patients with silent infarction and those without infarction.

Early diagnosis of neurologic involvement in BD is important and the NES is a useful instrument for detecting subclinical neurologic involvement in BD patients.