Neuro-Behcet disease

Case contributed by Dr Mohamed Abdel-Tawab Mohamed

Presentation

Motor deficit.

Patient Data

Age: 50 years
Gender: Male
Modality: MRI

Multiple abnormal signal intensity lesions are seen affecting the midbrain, right sided pons and posteromedial aspect of the right thalamus being hyperintense in FLAIR and T2WI and two of them are restricted in DWI in the right aspect of the pons and midbrain.

Modality: CT

CT of the same patient shows ill-defined brainstem and thalamic hypodensties that can be easily missed.

Case Discussion

This caucasian patient has known a history of Behcet disease with current oral ulcers. 

Behcet's disease is characterised by inflammatory perivasculitis, inflammation of the tissue around a blood or lymph vessel, in practically any tissue in the body. It is commonly associated with ulcers in the mouth and on the genitalia and inflammation around the eye.

Involvement of the nervous system is known as neuro-Behcet's disease (NBD).

Neuro-Behcet's disease has two types:

  1. parenchymal: affecting brainstem, thalamus, basal ganglia and spinal cord.
  2. non-parenchymal NBD, vascular complications such as cerebral venous thrombosis.

MRI is the modality of choice while CT has low sensitivity.

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Case Information

rID: 52693
Case created: 17th Apr 2017
Last edited: 21st Apr 2017
System: Head & Neck
Inclusion in quiz mode: Included

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