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KMID : 0359719970150020349
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Journal of the Korean Neurological Association
1997 Volume.15 No. 2 p.349 ~ p.357
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Neuro Behcet's Disease; Clinical, Cerebrospinal Fluid and Radiological Characteristics
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박선아
허지회/선우일남/조수진/이병인
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Abstract
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Background and Objectives :
@EN behcet's disease(BD) may develop variable neurologic manifestations. We herein report patients with neuroBD with special reference to clinical, cerence to clinical, cerebrospinal fluid(CSF), and radiological findings.
@ES Methods:
@EN Twenty-six patients, who fulfilled international BD criteria, were enrolled. Twenty-four of them fulfilled the criteriae at the time of, and another two at a three and four month follow-up after presenting neurological manifestations.
Twenty-two
patients had CSF examination. All but three patients had imaging studies (CT scan in 7 and MRI in 16). Results: Most patients with neuroBD presented with fooal neurologic deficits, followed by meningitic symptoms and behavioral changes or
cognitive
dysfunctions. The common initial neurological symptoms or signs were hypereflexia, headache, dysarthria, and disturbances of eye movement in order of frequency. One or more parameters of CSF examinations were abnormal in all but two patients.
Mean
WBC
count was 165±279/mm3 (9-1320). Nine of them were neutrophilic (polys .50%). Protein was mildly elevated up to 155 mg/dl. Neuroimaging studies showed abnormal findings in 18 patients (75%). Increased signal intensity on T2 weighted image was the
most
common finding. Basal ganglia, midbrain, pons and thalamus were the common sites of involvement in that of frequency. Although most patients had a lesion in the grain parenchyme or meninges, one patient had venous sinus thrombosis and another one
had
myelitis. Clinical outcomes were good in that all but three patients improved. However, 10 of them (38%) recurred during their follow-upperiod of average 36 months. Conclusions: our findings suggest that neuroBD may present with variable
neurologic
manifestations, and show characteristic neutrophilic CSF findings and multifocal brainstem or diencephalon involve ments. The frequent recurrence, despite their good clinical outcomes, points up the need for careful long-term neurologic
observations.
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KEYWORD
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