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Neurological Manifestation of Behçet’s Disease –  a Case Report


Authors: A. Tvaroh 1;  M. Vachová 1;  J. Bartoš 2
Authors‘ workplace: Krajská zdravotní, a. s., Nemocnice Teplice, o. z. Neurologické oddělení 1;  Krajská zdravotní, a. s., Nemocnice Teplice, o. z. Radiologické oddělení 2
Published in: Cesk Slov Neurol N 2015; 78/111(2): 223-228
Category: Case Report

Overview

The authors present a case report of a 41‑years‑ old woman with subacute onset of brainstem and pyramidal symp­toms, and a headache. Progression of the finding on magnetic resonance suggested brainstem parenchymal inflammation, and formation of multiple focal infarcts in the brainstem and the left thalamus and posterior branch of capsula interna. Serum and cerebrospinal fluid tests showed high inflammatory markers and no evidence of any infectious agent. Detailed history revealed long‑term systemic involvement presenting as recurrent oro‑genital ulcers accompanied with eye, joint, skin and gastrointestinal disorders. Differential dia­gnosis of focal brain changes is discussed, including inconsistent echocardiographic findings. The clinical course with systemic involvement, laboratory findings, and response to therapy support the dia­gnosis of Behçet’s disease with neurological manifestation.

Key words:
Behçet’s disease – meningoencephalitis – vasculitis of the central nervous system

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manu­script met the ICMJE “uniform requirements” for biomedical papers.


Sources

1. Biller J, Love BB. Ischemic cerebrovascular disease. In: Bradley WG, Daroff RB, Fenichel GM, Jankovic J (eds). Neurology in Clinical Practice. Principles of Dia­gnosis and Management. 4th ed. Philadelphia: Elsevier 2004: 1197– 1245.

2. Siva A, Altintas A, Saip S. Behçet’s syndrome and the nervous system. Curr Opin Neurol 2004; 17(3): 347– 357.

3. Kosztyuová T. Recidivujúce afty a Behçetova choroba. Dermatológia pre prax 2010; 4(2): 57– 59.

4. Younger DS. Vasculitis of the nervous system. Curr Opin Neurol 2004; 17(3): 317– 336.

5. Scolding NJ. Central nervous system vasculitis. Semin Immunopathol 2009; 31(4): 527– 536. doi: 10.1007/ s00281‑ 009‑ 0183‑ 2.

6. Berlit P. Dia­gnosis and treatment of cerebral vasculitis. Ther Adv Neurol Disord 2010; 3(1): 29– 42. doi: 10.1177/ 1756285609347123.

7. Alba MA, Espígol‑ Frigolé G, Prieto‑ González S, Tavera‑ Bahillo I, García‑ Martínez A, Butjosa M et al. Central nervous system vasculitis: still more questions than answers. Curr Neuropharmacol 2011; 9(3): 437– 448. doi: 10.2174/ 157015911796557920.

8. Žurek M. Systémová onemocnění pojiva –  díl 2. Dermatologie pro praxi 2010; 4(1): 33– 37.

9. International Study Group for Behçet’s Disease. Criteria for dia­gnosis of Behçet’s disease. Lancet 1990; 335(8697): 1078– 1080.

10. International Team fot the Revision of the International Kriteria for Behçet’s Disease. The International Criteria for Behçet’s Disease (ICBD): a collaborative study of 27 countries on the sensitivity and specifity of the new criteria. J Eur Acad Dermatos Venereol 2014; 28(3): 338– 347. doi: 10.1111/ jdv.12107.

11. Siva A, Saip S. The spectrum of nervous system involvement in Behçet’s syndrome and its differential dia­gnosis. J Neurol 2009; 256(4): 513– 529. doi: 10.1007/ s00415‑ 009‑ 0145‑ 6.

12. Al‑ Araji A, Kidd DP. Neuro‑Behçet disease: epidemiology, clinical characteristics, and management. Lancet Neurol 2009; 8(2): 192– 204. doi: 10.1016/ S1474‑ 4422(09)70015‑ 8.

13. Kalvach P. Mozkové ischemie. In: Kalvach P (ed). Mozkové ischemie a hemoragie. 3. vyd. Praha: Grada Publishing 2010: 83– 144.

14. Berlit P. Isolated angiitis of the CNS and bacterial endocarditis: similarities and differences. J Neurol 2009; 256(5): 792– 795. doi: 10.1007/ s00415‑ 009‑ 5018‑ 5.

15. Shoenfeld Y. Classification of anti‑endothelial cell antibodies into antibodies against microvascular and macrovascular endothelial cells: the pathogenic and dia­gnostic implications. Cleve Clin J Med 2002; 69 (Suppl 2): SII65– SII67.

16. Youinou P, Jamin C. The miscellany of anti‑endothelial cell autoantibodies Isr Med Assoc J 2012; 14(2): 119– 120.

17. Birnbaum J, Hellmann DB. Primary angiitis of the central nervous system. Arch Neurol 2009; 66(6): 704– 709. doi: 10.1001/ archneurol.2009.76.

18. Krtičková D, Slavík S, Jílek D. Behcetova choroba s neurologickými projevy (kazuistika). Alergie 2004; 6(1): 62– 66.

Labels
Paediatric neurology Neurosurgery Neurology

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Czech and Slovak Neurology and Neurosurgery

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2015 Issue 2

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