Neuro-Behcet's Disease: An Update on Diagnosis, Differential Diagnoses, and Treatment

Publication date: Available online 23 December 2019Source: Multiple Sclerosis and Related DisordersAuthor(s): Afshin Borhani-Haghighi, Bahareh Kardeh, Shubhasree Banerjee, Golnaz Yadollahikhales, Anahid Safari, Mohammadali Sahraian, Lee ShapiroAbstractNeuro-Behcet's disease (NBD) is defined as a combination of neurologic symptoms and/or signs in a patient with Behcet's disease (BD). Relevant syndromes include brainstem syndrome, multiple-sclerosis like presentations, movement disorders, meningoencephalitic syndrome, myelopathic syndrome, cerebral venous sinus thrombosis (CVST), and intracranial hypertension. Central nervous involvement falls into parenchymal and non-parenchymal subtypes. The parenchymal type is more prevalent and presents as brainstem, hemispheric, spinal, and meningoencephalitic manifestations. Non-parenchymal type includes CVST and arterial involvement. Perivascular infiltration of polymorphonuclear and mononuclear cells is seen in most histo-pathologic reports. In parenchymal NBD, cerebrospinal fluid (CSF) generally exhibits pleocytosis, increased protein and normal glucose. In NBD and CVST, CSF pressure is increased but content is usually normal. The typical acute NBD lesions in brain magnetic resonance imaging (MRI) are mesodiencephalic lesions. The pattern of extension from thalamus to midbrain provides a cascade sign. Brain MRI in chronic NBD usually shows brain or brainstem atrophy and/or black holes. The spinal MRI in the acute or subacute myelopathi...
Source: Multiple Sclerosis and Related Disorders - Category: Neurology Source Type: research