Seven-year follow-up of neurologic involvement in Behcet syndrome
G. Akman-Demir, B. Baykan-Kurt, P. Serdaroglu, H. Gurvit, S. Yurdakul, H. Yazici, S. Bahar and E. Aktin
Department of Neurology, Istanbul Faculty of Medicine, University of Istanbul, Turkey.
OBJECTIVE: To determine the long-term prognosis of neurologic involvement
in Behcet syndrome. DESIGN: Forty-six patients with Behcet 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-Behcet 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 Behcet syndrome. Patients should undergo periodic neurologic
evaluation. The long-term prognosis in neuro-Behcet syndrome does not seem
to be as favorable as we observed in short-term follow-up. Cerebrospinal
fluid findings may predict prognosis.
