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Nerve in 1 case report of Behcet's disease_13651

By Steve Wallace,2014-11-02 09:50
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Nerve in 1 case report of Behcet's disease_13651

Nerve in 1 case report of Behcet's disease

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     [Keywords:] neural Behcet's disease

     1 Clinical data

     Patients, male, 31 years old, repeated oral and scrotal pain, ulcer 10 years. Depending on the material distortion of the right eye, diplopia, recurrent 7 years, the right limbs not work 1 year, increased 1 week 27 May 2007 at admission. The patient in May 1997 there was no obvious incentive to the surface of mucosal ulceration of mouth and tongue after 1 week of painful genital ulcers that 1 ~ 2 weeks to heal, the

    recurrent symptoms, no systemic therapy .2000 4 suddenly appeared on his right eye, as objects were twisted, distorted, ophthalmic treatment outside hospital, diagnosed as "uveitis", improved with hormone therapy, but recurrent ocular symptoms.

    in May 2006 because of fever in patients with limb after right Activities not working the line the left side of the head MRI showed basal ganglia, lateral ventricle next to the see the small pieces long T2 signal. examination: vital signs were

    normal, visible facial acne, no genital ulcers. heart, lung, abdominal examination was normal. Neurological examination: Shen Qing, verbal fluency, advanced neurological examination was normal, no abnormal cranial nerve, right side, lower

    extremity muscle strength grade IV, right side slightly higher muscle tone, limb tendon reflexes were active and stronger than the left-right side. Shuang Zhang jaw reflex, Hoffmann sign, Babinski sign, Chaddock sign both (+), no meningeal irritation. auxiliary examination: RF (-), ASO (-), ESR20 mmP

    / L h, ANA antibodies, ds-DNA , ENA polypeptide antibodies,

    ANCA was normal. cerebrospinal fluid (CSF): protein 0.56 gP / L, total cell number 8, lymphocytes 3. India ink staining, acid fast stain was negative. evoked potentials: brainstem

    auditory evoked potential (BAEP) is not See abnormal visual evoked potential (VEP) abnormalities after right optic chiasm. to methylprednisolone 500 mg / d, 5 days, later changed to oral prednisone, gradually reducing. neurological symptoms

after the withdrawal .

     2 Discussion

     Behcet's disease small vessel vasculitis is the basic lesion of recurrent chronic progressive multi-system inflammatory

    disease. Mainly for mouth, eyes, genitalia, skin ulcers. Nervous system involvement in Behcet's disease only 8% to 10% However, a serious condition, causing great harm. brain parenchyma, meninges, brain and spinal nerves may be involved, central nervous system involvement than the peripheral nerve [1] .1990 Behcet's disease group in the development of

    international diagnostic criteria [2]: recurrent oral ulcers (at least 3 episodes) with the following conditions is 2 (1) recurrent genital ulcers; (2) eye injury; (3) skin lesions; (4) Acupuncture-positive . When violations of the nervous

    system called neural Behcet's disease, complex and diverse clinical manifestations, recurrent neurological symptoms, relapse, remission duration, combined with a number of sites involved at different times, mostly neurological Behcet's disease with acute, subacute onset, showing the progress of mitigation recurrent or persistent disease, nervous system damage are many and scattered lesions, the same patient in different periods and more sites may have nervous system involvement [3], susceptible to misdiagnosis and missed

    diagnosis. laboratory CRP, ESR and other changes and no specificity. auxiliary examination 96% sensitivity of MRI, most lesions in the brain stem, basal ganglia, cerebral hemisphere white matter, internal capsule, thalamus and spinal cord. typical manifestations of acute on T2 weighted images showed high signal, T 1-weighted as normal or low signal, and a significant enhancement (for circular, linear, crescent-

    shaped, irregular-shaped); recovery or chronic lesions

    decreased or disappeared, there may be cerebellar, brain stem atrophy of brain parenchyma, etc. change. The patients repeated oral, genital ulcers, signs of nervous system damage localization, in line with international classification standards committee Behcet's disease, Behcet's disease

    diagnosed as nervous. Currently corticosteroids and immunosuppressive drugs can most nervous patients with Behcet stable condition. early diagnosis and early treatment can help improve the prognosis.

     [References] 1] Liu Xiufeng. Neurological diagnosis of

    Behcet's disease affects the factors [J]. International

    Journal of Neurosurgery Volume, 1996,23: 159. [2] High Xiaoping, WANG Pei. Treating Behcet resolve 60 cases of Behcet's disease [J]. Gansu College, 2004, 21 (2) :28-31.

    [3] Su Yan fruit, Taiwan, on a firm, Dong Ruifang. Neural report of 2 cases with Behcet's disease [J]. Brain and Nervous System Diseases, 2007,15 (6): 466.

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