Table 1.
Cases | Age/Sex | BD findings | Complaints at admission | Physical examination | MRI and/or CT lesions | Biopsy | Treatment | Time of BD diagnosis (before or after neurologic manifestations) |
---|---|---|---|---|---|---|---|---|
Appenzeller et al. (1) | 43/female | OU GU Bilateral AU |
Headache Photophobia Asthenia |
Drowsiness, left arm and facial paresis, right eyelid ptosis | Thalamic lesion with mass effect and contrast enhancement | Gliosis with gemistocytic astrocytes | Steroid CYC | Before |
Tuzgen et al. (4) | 59/female | OU, GU | Left hemiparesis, lethargy, sensations of bad smell, headache | Left hemiparesis, bilateral papilloedema vascular proliferation | Right frontotemporal mass causing shift | Reactive gliosis, panvasculitis, thrombosis, extensive infarction, | Right frontotemporal craniotomy and subtotal excision | After |
Tuzgen et al. (4) | 45/female | OU, GU, monoarthritis | Headache, right hemiparesis, somnolence | Right hemiparesis | Mass in the left mesodiencephalic junction | Biopsy was not performed | Steroid | After |
Heo et al. (5) | 47/male | OU, GU, uveitis | Headache Right side Weakness Vomiting |
Right hemiparesis, dysarthria | GdT1I showed ring enhancing lesions with internal hypointensities with subtle perilesional oedema at left side of the pons and parietal cortex | Frequent perivascular lymphocytic cuffing, focal necrotic lesion, microglial nodules, foci of necrosis, foamy hystiocytic collections, reactive gliosis | Steroid | Before |
Darmoul et al. (7) | 38/Male | Folliculitis | Headache, aphasia, disturbed consciousness | Right hemiplegia | Pseudotumoral lesion in the left capsulo-thalamic region extending to the homolateral peduncle | Biopsy was not performed | Steroid Immunsupresive theraphy | After |
Imoto et al. (9) | 50/male | OU, GU, Skin eruption | Dystasia dysbasia | Left hemiparesis (+) left Babinski reflex dysarthria | Low density area with significant mass effect in the right basal ganglia and thalamus with ring like enhancement following contrast injection | Large numbers of chronic inflammatory cells mainly in the Virchow robin spaces | Steroid | After |
Schmolck et al. (10) | 39/male | OU, GU | Recurrent aseptic meningitis, diplopia, dysarthria | Right sensorimotor hemiparesis with hyperreflexia, right sided dysmetria, disdiadochokinesis, ataxic gait | Lesion in the left thalamus with patchy contrast enhancement and mass effect | Steroid CYC | Before | |
Matsuo et al. (11) | 33/male | OU, GU, EN | Nausea, vomiting, headache | Mild right hemiparesis | Mass lesion at the left basal ganglia extending to the ventral side of the midbrain | Mild reactive gliosis | Steroid | Before |
Bennett et al. (12) | 23/Male | OU, GU, papulopustular rash | Headache, fever, progressive right sided weakness | Right homonymous hemianopia, right spastic hemiparesis | Mass lesion involving the left temporal lobe | Perivascular inflammatory infiltrate, no neoplasia | Steroid, AZA | Before |
Yoshimura et al. (13) | 41/Female | OU, GU, EN | Mental deterioration, right hemiparesis | Poor mental activity, dysarthria and right hemiparesis | Homogeneous hypodense lesion of the left lenticulothalamic region, mild mass effect | Ruled out a tumour but did not show any specific diagnosis | Steroid | After |
Ben Taarit et al.14 | 26/Female | OU, GU | Left hemiplegia | Pseudotumoral lesion in the protuberance and the right cerebral pedicule | Steroid | After | ||
Park et al.15 | 52/female | OU, EN like skin lesion and arthritis | Dizziness, nausea, vomiting | Brun’s nystagmus | T2WI showed high signal intensity in the right cerebellar hemisphere, post medulla, pons with an isosignal central mass, GdT1WI showed homogenously enhancing mass like lesion inside the T2 high signal intensity | Biopsy was not performed | Steroid AZA | After |
Presented case | 27/Female | OU, GU, skin lesions | Headache, vomiting | Left hemiparesis | hyperintense lesion in the brainstem | Biopsy was not performed | Steroid AZA | After |
NB: neuro-Behçet; MLL: mass-like lesion; BD: Behçet’s disease; MRI: magnetic resonance imaging; CT: computerised tomography; OU: oral ulcer; GU: genital ulcer; AU: anterior uveitis; EN: erythema nodosum; CYC: cyclophosphamide; AZA: azathiopurin