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Neuro-Behcet's: a diagnostic challenge.

Mohan MC, Koya JM, Kandaswamy GV, Jaleel VA, Jimnaz PA, Manjuhasan S, Ravindran V - Oxf Med Case Reports (2015)

Bottom Line: Various viral encephalitides are important differential diagnoses.MRI may aid the correct diagnosis.This case report describes a patient with acute severe neurological involvement due to neuro-BD.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Internal Medicine , MES Medical College , Perinthalmanna, Kerala , India.

ABSTRACT
Behcet's disease (BD) is characterized by recurrent oral and genital ulcers and uveitis. It is also known to affect various organs; however, central nervous system involvement is rare and may cause parenchymal or vascular lesions with distinct clinical syndromes. Various viral encephalitides are important differential diagnoses. MRI may aid the correct diagnosis. This case report describes a patient with acute severe neurological involvement due to neuro-BD.

No MeSH data available.


Related in: MedlinePlus

MRI showing bilateral internal capsule involvement.
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OMV046F4: MRI showing bilateral internal capsule involvement.

Mentions: An MRI study of the brain and whole spine showed multiple symmetrical non-enhancing foci of altered signal intensity in the brainstem, hypothalami, posterior limb of internal capsule and splenium of corpus callosum (Figs 3 and 4), and also the spinal cord in keeping with BD causing neurological involvement (neuro-BD). The later availability of negative CSF PCR for HSV, Japanese encephalitis and West Nile virus strengthened this diagnosis. She was then treated with five doses of intravenous methylprednisolone on consecutive days, along with colchicine and other supportive measures comprising care of the genital ulcers with topical agents, water bed to prevent bed sores, physiotherapy and nutritional inputs. A week later, she was conscious and was obeying verbal commands and was moving left limbs. Follow-up treatment consisted of oral tapering prednisolone and azathioprine. The patient was discharged home with neurorehabilitation and subsequent follow-ups have found her to be in good health with only minor residual paresis.Figure 3:


Neuro-Behcet's: a diagnostic challenge.

Mohan MC, Koya JM, Kandaswamy GV, Jaleel VA, Jimnaz PA, Manjuhasan S, Ravindran V - Oxf Med Case Reports (2015)

MRI showing bilateral internal capsule involvement.
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4584512&req=5

OMV046F4: MRI showing bilateral internal capsule involvement.
Mentions: An MRI study of the brain and whole spine showed multiple symmetrical non-enhancing foci of altered signal intensity in the brainstem, hypothalami, posterior limb of internal capsule and splenium of corpus callosum (Figs 3 and 4), and also the spinal cord in keeping with BD causing neurological involvement (neuro-BD). The later availability of negative CSF PCR for HSV, Japanese encephalitis and West Nile virus strengthened this diagnosis. She was then treated with five doses of intravenous methylprednisolone on consecutive days, along with colchicine and other supportive measures comprising care of the genital ulcers with topical agents, water bed to prevent bed sores, physiotherapy and nutritional inputs. A week later, she was conscious and was obeying verbal commands and was moving left limbs. Follow-up treatment consisted of oral tapering prednisolone and azathioprine. The patient was discharged home with neurorehabilitation and subsequent follow-ups have found her to be in good health with only minor residual paresis.Figure 3:

Bottom Line: Various viral encephalitides are important differential diagnoses.MRI may aid the correct diagnosis.This case report describes a patient with acute severe neurological involvement due to neuro-BD.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Internal Medicine , MES Medical College , Perinthalmanna, Kerala , India.

ABSTRACT
Behcet's disease (BD) is characterized by recurrent oral and genital ulcers and uveitis. It is also known to affect various organs; however, central nervous system involvement is rare and may cause parenchymal or vascular lesions with distinct clinical syndromes. Various viral encephalitides are important differential diagnoses. MRI may aid the correct diagnosis. This case report describes a patient with acute severe neurological involvement due to neuro-BD.

No MeSH data available.


Related in: MedlinePlus