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Gülen Akman-Demir, MD; Betül Baykan-Kurt, MD; Piraye Serdarolu, MD; Hakan Gürvit, MD; Sabahattin Yurdakul, MD; Hasan Yazici, MD; Sara Bahar, MD; Edip Aktin, MD

Arch Neurol. 1996;53(7):691-694.

Abstract
Objective
To determine the long-term prognosis of neurologic involvement in Behçet syndrome.

Design
Forty-six patients with Behçet syndrome, who had been the subjects of a previous report with short-term follow-up, were reexamined 7 years later; 42 of them could be reexamined neurologically. Neuropsychological testing, magnetic resonance imaging, electromyography, and evoked potential studies were performed when available.

Results
Of the 27 patients who had had headaches without any neurologic symptoms or signs previously, 2 had developed an acute neurologic attack. In addition, 7 patients in this group showed minor abnormalities on neurologic examination and/or other laboratory investigations, without history of any attacks. Among the previous neuro-Behçet group (n=15), as defined by the presence of neurologic signs or symptoms, other than headache, 7 had a stationary course, while 8 had been progressive. Three of the latter group had died. Patients with progressive course had had abnormal cerebrospinal fluid findings at the time of the previous report, whereas patients with a stationary course had not.

Conclusions
Silent neurologic involvement may occur in Behçet syndrome. Patients should undergo periodic neurologic evaluation. The long-term prognosis in neuro-Behçet syndrome does not seem to be as favorable as we observed in short-term follow-up. Cerebrospinal fluid findings may predict prognosis.

Author Affiliations
From the Department of Neurology (Drs Akman-Demir, Baykan-Kurt, Serdarolu, Gürvit, Bahar, and Aktin), Istanbul (Turkey) Faculty of Medicine, and Department of Internal Medicine, Rheumatology Division (Drs Yurdakul and Yazici), Cerrahpaa Faculty of Medicine, University of Istanbul.

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