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Case Reports
. 2024 Aug 30;16(8):e68236.
doi: 10.7759/cureus.68236. eCollection 2024 Aug.

Neuro-Behçet Disease Presenting as a Bulbar Lesion: A Case Report

Mariana Certal  1 , Ana Sofia Alves  2 , Marta B Santos  1 , Fernando Salvador  2 , Michel Mendes  3
Affiliations
Case Reports

Neuro-Behçet Disease Presenting as a Bulbar Lesion: A Case Report

Mariana Certal et al. Cureus. .

Abstract

Behçet's disease (BD), also called neuro-Behçet (NB), is a multisystem inflammatory disease that can affect the nervous system. The authors hereby present the case of a 46-year-old woman with a previous diagnosis of BD with cutaneous, articular, and ocular involvement. The patient was admitted to the emergency room with intense posterior cervical pain, right eyelid ptosis accompanied by anisocoria, left arm hemiparesis, left hemihypoesthesia, right dysmetria, and postural instability. A cerebral MRI revealed a right laterobulbar oval T2 hyperintense lesion, suggesting a diagnosis of NB. Treatment with methylprednisolone pulses and, later, azathioprine was then started. The patient showed progressive improvement in her clinical condition and an imagological resolution of the bulbar lesion. This case highlights the importance of an accurate diagnosis - based on clinical history and imaging studies - for an early initiation of the specific therapy.

Keywords: behçet’s disease; immune inflammatory disease; nervous system; neurobehçet; wallenberg’s syndrome.

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Conflict of interest statement

Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Brain MRI.
T2-weighted in coronal (A) and axial (B) slices revealing a hyperintense lesion, right laterobulbar, and slightly hyperintense on DWI sequence (C). MRA without signs suggestive of dissection or vasculitis (D, E). Subsequent coronal slice showing a shrunken bulbar lesion on T2 weighting (F).
See this image and copyright information in PMC

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