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July 1996

Seven-Year Follow-up of Neurologic Involvement in Behçet Syndrome

Author Affiliations

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

Arch Neurol. 1996;53(7):691-694. doi:10.1001/archneur.1996.00550070133022

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.