Case 17-2009: A 30-year-old man with progressive neurologic deficits

New England Journal of Medicine

Volumn 360, Issue 22, 2009, Pages 2341-2351

  Greer, David M ^a,b   Friday, Robert P ^a,b   Romero, Javier ^a,b   Auluck, Pavan K ^a,b  

^a MASSACHUSETTS GENERAL HOSPITAL   (United States)

^b HARVARD MEDICAL SCHOOL   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ALPHA INTERFERON; ANTICONVULSIVE AGENT; ANTINUCLEAR ANTIBODY; AZATHIOPRINE; COLCHICINE; CORTICOSTEROID; CYCLOPHOSPHAMIDE; INFLIXIMAB; METHOTREXATE; MYCOPHENOLIC ACID 2 MORPHOLINOETHYL ESTER; PHENYTOIN; PREDNISONE; VALPROIC ACID; ANTIINFLAMMATORY AGENT; IMMUNOSUPPRESSIVE AGENT;

ADULT; ARTHRITIS; ARTICLE; AUTOPSY; BEHCET DISEASE; BRAIN BIOPSY; CASE REPORT; CEREBROSPINAL FLUID ANALYSIS; CONTRAST ENHANCEMENT; DEMYELINATING DISEASE; DIFFERENTIAL DIAGNOSIS; DRUG DOSE REDUCTION; DRUG MEGADOSE; DRUG WITHDRAWAL; ELECTROENCEPHALOGRAM; GIANT CELL ARTERITIS; HEADACHE; HERPES SIMPLEX VIRUS 1; HERPES SIMPLEX VIRUS 2; HISTOPATHOLOGY; HUMAN; MALE; MOUTH ULCER; NEURO BEHCET DISEASE; NEUROIMAGING; NEUROLOGIC DISEASE; NEUROSYPHILIS; NUCLEAR MAGNETIC RESONANCE IMAGING; PRIORITY JOURNAL; RASH; SKIN BIOPSY; SKIN DEFECT; SYMPTOMATOLOGY; SYSTEMIC LUPUS ERYTHEMATOSUS; TONIC CLONIC SEIZURE; VOGT KOYANAGI SYNDROME; WEGENER GRANULOMATOSIS; WORD LIST RECALL; BRAIN; BRAIN DISEASE; CEREBROSPINAL FLUID; CHEMISTRY; CLINICAL OBSERVATION; CLINICAL STUDY; COMMUNICABLE DISEASE; CYTOLOGY; DIAGNOSIS; ERYTHEMA; FATALITY; GENITAL SYSTEM DISEASE; PATHOLOGY; VASCULITIS;

ADULT; ANTI-INFLAMMATORY AGENTS; BEHCET SYNDROME; BRAIN; BRAIN DISEASES; CEREBROSPINAL FLUID; COMMUNICABLE DISEASES; DEMYELINATING DISEASES; DIAGNOSIS, DIFFERENTIAL; ERYTHEMA; FATAL OUTCOME; GENITAL DISEASES, MALE; HUMANS; IMMUNOSUPPRESSIVE AGENTS; MAGNETIC RESONANCE IMAGING; MALE; NERVOUS SYSTEM DISEASES; VASCULITIS;

EID: 66249085506     PISSN: 00284793     EISSN: 15334406     Source Type: Journal    
DOI: 10.1056/NEJMcpc0810842     Document Type: Article

References (35)

1. Koçer N, Islak C, Siva A, et al. CNS involvement in neuro-Behçet syndrome: an MR study. AJNR Am J Neuroradiol 1999;20:1015-1024 (Pubitemid 29536207)
2. Serdaroǧlu P. Behçet's disease and the nervous system. J Neurol 1998;245:197-205. (Pubitemid 28192693)
3. Hindmarsh T, Lindqvist M, Olding-Stenkvist E, Sköldenberg B, Forsgren M. Accuracy of computed tomography in the diagnosis of herpes simplex encephalitis. Acta Radiol Suppl 1986;369:192-196
4. Luxon L, Lees AJ, Greenwood RJ. Neurosyphilis today. Lancet 1979;1:90-93 (Pubitemid 9089875)
5. Donahue JG, Choo PW, Manson JE, Platt R. The incidence of herpes zoster. Arch Intern Med 1995;155:1605-1609
6. Orloski KA, Hayes EB, Campbell GL, Dennis DT. Surveillance for Lyme disease - United States, 1992-1998. MMWR CDC Surveill Summ 2000;49:1-11.
7. Koch M, Uyttenboogaart M, Polman S, De Keyser J. Seizures in multiple sclerosis. Epilepsia 2008;49:948-953
8. Chin RL, Latov N. Central nervous system manifestations of rheumatologic diseases. Curr Opin Rheumatol 2005;17:91-99 (Pubitemid 40075654)
9. Bihan H, Christozova V, Dumas JL, et al. Sarcoidosis: clinical, hormonal, and magnetic resonance imaging (MRI) manifestations of hypothalamic-pituitary disease in 9 patients and review of the literature. Medicine (Baltimore) 2007;86:259-268 (Pubitemid 47415004)
10. Naranjo A, Carmona L, Gavrila D, et al. Prevalence and associated factors of anterior atlantoaxial luxation in a nationwide sample of rheumatoid arthritis patients. Clin Exp Rheumatol 2004;22:427-432 (Pubitemid 39099118)
11. Young AW Jr. Cutaneous inflammations of the male genitalia. Mod Treat 1970;7:973-998
12. Spranger M, Schwab S, Meinck HM, et al. Meningeal involvement in Wegener's granulomatosis confirmed and monitored by positive circulating antineutrophil cytoplasm in cerebrospinal fluid. Neurology 1997;48:263-265 (Pubitemid 27039553)
13. Carr J, Bryer A. An isolated myelopathy as a presentation of polyarteritis nodosa. Br J Rheumatol 1993;32:644. (Pubitemid 23224951)
14. Rosenblatt BJ, Foroozan R, Savino PJ. Asymptomatic optic neuropathy associated with Churg-Strauss syndrome. Ophthalmology 2003;110:1650-1652 (Pubitemid 36962505)
15. Calabrese LH, Mallek JA. Primary angiitis of the central nervous system: report of 8 new cases, review of the literature, and proposal for diagnostic criteria. Medicine (Baltimore) 1988;67:20-39. (Pubitemid 18064304)
16. Tsai JH, Sukavatcharin S, Rao NA. Utility of lumbar puncture in diagnosis of Vogt-Koyanagi-Harada disease. Int Ophthalmol 2007;27:189-194 (Pubitemid 46909260)
17. Bang DS, Oh SH, Lee KH, Lee ES, Lee SN. Influence of sex on patients with Behçet's disease in Korea. J Korean Med Sci 2003;18:231-235
18. International Study Group for Behçet's Disease. Criteria for diagnosis of Behçet's disease. Lancet 1990;335:1078-1080
19. Deuter CM, Kötter I, Wallace GR, Murray PI, Stübiger N, Zierhut M. Behçet's disease: ocular effects and treatment. Prog Retin Eye Res 2008;27:111-136
20. Siva A, Altintas A, Saip S. Behçet's syndrome and the nervous system. Curr Opin Neurol 2004;17:347-357 (Pubitemid 38720989)
21. Akman-Demir G, Serdaroglu P, Tasçi B. Clinical patterns of neurological involvement in Behçet's disease: evaluation of 200 patients. Brain 1999;122:2171-2182
22. Kidd D, Steuer A, Denman AM, Rudge P. Neurological complications in Behçet's syndrome. Brain 1999;122:2183-2194
23. Akman-Demir G, Bahar S, Coban O, Tasci B, Serdaroglu P. Cranial MRI in Behçet's disease: 134 examinations of 98 patients. Neuroradiology 2003;45:851-859 (Pubitemid 38072254)
24. Serdaroǧlu P, Yazici H, Ozdemir C, Yurdakul S, Bahar S, Aktin E. Neurologic involvement in Behçet's syndrome: a prospective study. Arch Neurol 1989;46:265-269 (Pubitemid 19070223)
25. Hamuryudan V, Ozyazgan Y, Hizli N, et al. Azathioprine in Behçet's syndrome: effects on long-term prognosis. Arthritis Rheum 1997;40:769-774 (Pubitemid 127744665)
26. Hatemi G, Silman A, Bang D, et al. Management of Behçet's disease: a systematic literature review for the EULAR evidence based recommendations for the management of Behçet's disease. Ann Rheum Dis 2008 April 17 (Epub ahead of print).
27. Kötter I, Gönaydin I, Batra M, et al. CNS involvement occurs more frequently in patients with Behçet's disease under cyclosporin A (CSA) than under other medications - results of a retrospective analysis of 117 cases. Clin Rheumatol 2006;25:482-486 (Pubitemid 44137619)
28. Tirilomis T. Some more historical notes on Adamantiades-Behçet's disease. Chest 2001;120:2116. (Pubitemid 34053486)
29. Sfikakis PP, Markomichelakis N, Alpsoy E, et al. Anti-TNF therapy in the management of Behçet's disease - review and basis for recommendations. Rheumatology (Oxford) 2007;46:736-741 (Pubitemid 47061701)
30. Pipitone N, Olivieri I, Padula A, et al. Infliximab for the treatment of neuro-Behçet's disease: a case series and review of the literature. Arthritis Rheum 2008;59:285-290
31. Al-Araji A, Kidd DP. Neuro-Behçet's disease: epidemiology, clinical characteristics, and management. Lancet Neurol 2009;8:192-204.
32. Borhani Haghighi A. Treatment of neuro-Behçet's disease: an update. Expert Rev Neurother 2009;9:565-574
33. Arai Y, Kohno S, Takahashi Y, Miyajima Y, Tsutusi Y. Autopsy case of neuro-Behçet's disease with multifocal neutrophilic perivascular inflammation. Neuropathology 2006;26:579-585 (Pubitemid 44800296)
34. Hadfield MG, Aydin F, Lippman HR, Sanders KM. Neuro-Behçet's disease. Clin Neuropathol 1997;16:55-60. (Pubitemid 27128100)
35. Hirohata S. Histopathology of central nervous system lesions in Behçet's disease. J Neurol Sci 2008;267:41-47