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E-Pearls of the Week: Neuro-Behcet disease

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Brought to you by the Residents & Fellows Section of Neurology®.

June 11, 2013

Neurologic complications of Behcet's disease were first described in 1993.  The frequency of neurologic involvement ranges from 5-10%. Sequelae can include subacute meningoencephalitis, vascular thromboses, and intra- as well as extra-cranial aneurysms. MRI is critical in diagnosis and establishes evidence for parenchymal damage. A recent case series of pediatric patients with Neuro-Behcet's disease revealed 89% had cerebral venous sinus thrombosis and 11% had parenchymal damage. The most common symptoms were headache, seizure, ophthalmoparesis, and hemiplegia. The acute treatment of Neuro-Behcet's disease includes immunomodulation with high-dose corticosteroids with good outcome in the majority of cases. Long-term treatment is often guided by the systemic symptoms and includes azathioprine, cyclophosphamide, and TNF-alpha inhibitors. 

References

1. Adnan Al-Araji, and Desmond P Kidd Neuro-Behçet's disease: epidemiology, clinical characteristics, and management. Lancet Neurology 2009; 8: 192-204.

2.  Uluduz D, Kürtüncü M, Yapıcı Z et al. Clinical characteristics of pediatric-onset neuro-Behçet disease. Neurology 2011; 77: 1900-1905.

Submitted by Adam Numis, M.D. Resident Physician, University of California, San Francisco

Disclosure: Dr. Numis serves on the editorial team for the Neurology Resident and Fellow Section.

For more clinical pearls and other articles of interest to neurology trainees, visit the Neurology Residents & Fellows page.  Listen to this week's Neurology Podcast.

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