Neuro-Behçet disease presenting with oculopalatal tremor

Area of Science:

• Neurology
• Ophthalmology
• Rheumatology

Background:

• Behçet disease is a multisystem vasculitis that can affect the central nervous system.
• Neuro-Behçet disease can manifest with various neurological symptoms, including ocular motor abnormalities.
• Postpartum onset of neurological symptoms in patients with Behçet disease warrants thorough investigation.

Observation:

• A 39-year-old woman with known Behçet disease presented with new-onset oscillopsia after childbirth.
• Clinical examination revealed oculopalatal tremor (OPT), a rhythmic involuntary movement of the palate and ocular muscles.
• Videographic documentation confirmed the presence and characteristics of the oculopalatal tremor.

Findings:

• Brain magnetic resonance imaging (MRI) demonstrated bilateral pseudohypertrophy of the inferior olivary nuclei, a hallmark finding in OPT.
• The neuroimaging findings were consistent with a diagnosis of oculopalatal tremor.
• The patient's symptoms were presumed to be secondary to neuro-Behçet disease.

Implications:

• This case highlights a rare presentation of neuro-Behçet disease with oculopalatal tremor.
• Early diagnosis and management of OPT in Behçet disease patients are crucial for preventing further neurological damage.
• Gabapentin may be an effective treatment option for managing oculopalatal tremor in this patient population.