Neuro-Behçet Disease Presenting as a Bulbar Lesion: A Case Report

Behçet's disease (BD), also called neuro-Behçet (NB), is a multisystem inflammatory disease that can affect the nervous system. The authors hereby present the case of a 46-year-old woman with a previous diagnosis of BD with cutaneous, articular, and ocular involvement. The patient was admitted to the emergency room with intense posterior cervical pain, right eyelid ptosis accompanied by anisocoria, left arm hemiparesis, left hemihypoesthesia, right dysmetria, and postural instability. A cerebral MRI revealed a right laterobulbar oval T2 hyperintense lesion, suggesting a diagnosis of NB. Treatment with methylprednisolone pulses and, later, azathioprine was then started. The patient showed progressive improvement in her clinical condition and an imagological resolution of the bulbar lesion. This case highlights the importance of an accurate diagnosis - based on clinical history and imaging studies - for an early initiation of the specific therapy.