Neuro-Behcet Disease with Recurrent Cerebral Infarction: A case report

ABSTRACT

Behcet disease defined as multisystemic vasculitis of unknown origin in which musculoskeletal, cardiovascular, gastrointestinal, pulmonary and/or central nervous system were involved. Neurological involvement is one of the most devastating manifestation of Behcet disease. We experienced a patient who was a 42-year-old female, admitted for right hemiplegia and dysarthria with high fever and she had been diagnosed as tuberculous meningitis at first. The physical examination revealed recurrent oral and genital ulcerated lesion. The brain MRI showed multifocal infarctions in medulla, pons, midbrain, both posterior limb of internal capsule and left periventricular white matter. After 6 months, she was aggravated right hemiplegia with erythematous skin lesion. The follow-up brain MRI showed the inactivated non-enhanced multifocal lesions compared with previous findings. So we confirmed neuro-Betchet disease and started immunosuppressive therapy with steroid, but despite of intensive care she was bedridden state at discharge and expired with septic pneumonia 8 months later. We report the neuro-Behcet disease with recurrent cerebral infarction showing poor prognosis.