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Parkinsonian Syndrome as a Neurological Manifestation of Behcet's Disease

Published online by Cambridge University Press:  18 September 2015

D. Bogdanova ,
I. Milanov  and
D. Georgiev
D. Bogdanova*
Affiliation:
University Hospital for Neurology and Psychiatry-IV kilometre, Sofia, III Neurological Clinic
I. Milanov
Affiliation:
University Hospital for Neurology and Psychiatry-IV kilometre, Sofia, III Neurological Clinic
D. Georgiev
Affiliation:
University Hospital for Neurology and Psychiatry-IV kilometre, Sofia, III Neurological Clinic
*
University Neurological Hospital, Tzarigradsko shosse Blvd. IV kilometre, 1113, Sofia,Bulgaria
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Abstract:

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Background:

The central nervous system is often involved in Behcet's disease. Most common are meningoencephalitic and brain stem syndromes. Although basal ganglia involvement is not an uncommon finding on necropsy, there are only single reports on extrapyramidal syndromes-dyskinesia, chorea and Parkinsonism in patients with Behcet's disease.

Case study:

We report a patient fulfilling the criteria of the International Study Group for Behcet's disease. He had recurrent oral ulcerations, bilateral posterior uveitis and retinal vasculitis, skin papules and pustules, and recurrent monoarthritis. Neurologic examination revealed pseudobulbar palsy, slight and asymmetric bilateral pyramidal syndrome, muscle rigidity involving the four limbs, bradykinesia, masked face, and impaired postural reflexes. There was postural tremor in the extremities and myoclonic jerks involving the tongue and face muscles. Magnetic resonance imaging demonstrated small bilateral multifocal hyperintense lesions, with right predilection, involving the periventricular white matter, brain stem and basal ganglia.

Conclusions:

The Parkinsonian syndrome found in our patient might be due to involvement of both substantia nigra and basal ganglia. This case further emphasizes the wide spectrum of the neurological manifestations of Behcet's disease

Type
Original Articles
Information
Canadian Journal of Neurological Sciences , Volume 25 , Issue 1 , February 1998 , pp. 82 - 85
Copyright
Copyright © Canadian Neurological Sciences Federation 1998

References

REFERENCES

1.Behcet, H. Uber rezidivierende aphtose durch ein Virus verursachteGeschwure am Mund am Auge und den Genitalien. Derm Wochenschr 1937; 36: 1152–1157.Google Scholar
2.O’Duffy, JD, Goldstein, NP. Neurologic involvement in seven patients with Behcet’s disease. Am J Med 1976; 61: 170–178.CrossRefGoogle ScholarPubMed
3.O’Duffy, JD. Vasculitis in Behcet’s disease. Rheum Clin North Am Vasculitic Syndromes 1990; 16: 423–432.CrossRefGoogle ScholarPubMed
4.Chajek, T, Fainaru, M. Behcet’s disease. Report of 41 cases and a review of the literature. Medicine 1975; 54: 179–196.CrossRefGoogle Scholar
5.Wechsler, B, Vidailhet, M, Piette, JC, et al. Cerebral venous thrombosis in Behcet’s disease. Neurology 1992; 42: 614–618.CrossRefGoogle ScholarPubMed
6.Serdaroglu, P, Yazici, H, Ozdemir, C, et al. Neurological involvement in Behcet’s syndrome. Arch Neurol 1989; 46: 265–269.CrossRefGoogle ScholarPubMed
7.Akman-Demir, G, Baycan-Kurt, B, Serdaroglu, P, et al. Seven-year follow-up of neurologic involvement in Behcet syndrome. Arch Neurol 1996;53:691–694.CrossRefGoogle ScholarPubMed
8.Akman-Demir, G, Bahar, S, Baycan-Kurt, B, Gurvit, HI, Serdaroglu P. Intracranial hypertension in Behcet’s disease. Eur J Neurol 1996; 3: 66–70.CrossRefGoogle Scholar
9.Bahar, S, Coban, O, Gurvit, H, Akman-Demir, G, Gokyigit, A. Spontaneous dissection of the extracranial vertebral artery with spinal subarachnoid haemorrage in a patient with Behcet’s syndrome. Neuroradiology 1993; 35: 352–354.CrossRefGoogle Scholar
10.Gulsen, F, Akman-Demir, G, Eraksoy, M, et al. Paroxysmal dysarthria and ataxia in a patient with Behcet’s disease. J Neurol 1995; 242: 344–347.Google Scholar
11.Alema, G, Bignami, A. Involvement of the nervous system in Behcet’s disease. In: Monacelli, M, Nazarro, P, eds. Behcet’s Disease. Proceedings of International Symposium on Behcet’s Disease, Rome. Basel / New York: Karger, 1966: 52–66.Google Scholar
12.Terao, Y, Hayashi, H, Shimizu, T, et al. Altered motorcortical excitability to magnetic stimulation in a patient with a lesion in globus pallidus. J Neurol Sci 1995; 129(2): 175–178.CrossRefGoogle Scholar
13.Bussone, G, La Mantia, L, Boiardi, A, Giovannini, P. Chorea in Behcet’s syndrome. J Neurol 1982; 227(2): 89–92.CrossRefGoogle ScholarPubMed
14.Hughes, RAC, Lehner, T. Neurological aspects of Behcet’s syndrome. In: Lehner, T, Barnes, CG, eds. Behcet’s Syndrome. Clinical and Immunological Features. Proceedings of a conference. London: Academic Press Ins, 1979: 13–33.Google Scholar
15.International Study Group for Behcet’s disease. Criteria for diagnosis of Behcet’s disease. Lancet 1990; 335: 1078–1080.Google Scholar
16.Tan, E, Cohen, A, Fries, J, et al. The 1982 Revised Criteria for the classification of Systemic Lupus Erythematosus. Arthritis Rheum, vol. 25, Nl 1 (Nov. 1982).CrossRefGoogle ScholarPubMed
17.Wechsler, B, Dell’Isola, B, Vidailhet, M, et al. MRI in 31 patients with Behcet’s disease and neurological involvement: prospective study with clinical correlation. J Neurol Neurosurg Psychiatry 1993; 56(7): 793–798.CrossRefGoogle ScholarPubMed
18.Miller, D. Neurologic manifestations of collagen-vascular disease. In: Asbury, A, McDonald, W, McKhann, G, eds. Diseases of the Nervous System. Clinical Neurobiology. Philadelphia: W.B. Saunders Company, 1993: 1480–1481.Google Scholar
19.Lehner, T, Batchelor, JR. Classification and an immunogenetic basis of Behcet’s syndrome. In: Lehner, T, Barnes, CS, eds. Behcet’s Syndrome. Clinical and Immunological features. Proceedings of a conference. London: Academic Press Ins, 1979: 241–259.Google Scholar
20.Jongen, PJ, Daelmans, HE, Bruneel, B, Den Hartog, MR. Humoral and cellular immunologic study of cerebrospinal fluid in a patient with Behcet encephalitis. Arch Neurol 1992; 49(10): 1075–1078.CrossRefGoogle Scholar
21.Klok, AM, Geertzen, R, Rothova, A, Baarsma, GS, Kijlstra, A. Anticardiolipin antibodies in uveitis. Curr Eye Res 1992; Suppl 11:209–213.CrossRefGoogle ScholarPubMed
22.Boggild, MD, Sedhev, RV, Fraser, D, Heron, JR. Cerebral venous thrombosis and antiphospholipid antibodies. Postgrad Med J 1995; 71(838): 487–489.CrossRefGoogle ScholarPubMed
23.Elble, RJ. Physiologic and essential tremor. Neurology 1986; 36: 225–231.CrossRefGoogle ScholarPubMed
24.Hadar, U, Rose, FC. Is Parkinsonian arm tremor a resting tremor? Eur Neurol 1993;33:221–228.CrossRefGoogle ScholarPubMed
25.Berlin, C. Behcet’s syndrome with involvement of the central nervous system. Report of a case with necropsy. Arch Derm Syph (Chicago) 1944; 49: 227–233.CrossRefGoogle Scholar