الفهرس 
REVIEW OF LITERATUREOnly 14 pages are availabe for public view
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Abstract
Neurological involvement in Behcet’s Disease (BD)
that used to be considered uncommon seems to be frequent and
may antedate other typical features of the disease. It has been
therefore, suggested that it should be added to the new
diagnostic criteria for BD.
When neurological complications are present,
morbidity and mortality rates rise, and before the advent of
cytotoxic immunosuppressive therapies, death frequently
occurred within one ye~ from the onset of neurologic signs.
It’s not known if subclinical neurological affection
demonstrated by EP s or MRI carries the same serious
prognosis as overt cases, but this assumption seems feasible
and justifies searching for such subclinical lesions. Therefore,
early diagnosis and aggressive treatment is essential m
reducing or preventing progression of CNS disease.
Any part of the neuraxis may be involved and there is
no characteristic clinical pattern of the disease. Like the
pathological and morphological findings, laboratory, standard
radiological and EEG studies are normal or show no specific
changes.
We tried to explore the potential usefulness ofMRI
and EPs namely (BAEP & SEPs)as regards early and objective
demonstration of clinical and subclinical CNS involvement in
a group of 20 BD patients with and without CNS involvement seen at Ain Shams University Hospital, Ain Shams Specialized
Hospital and Al-Maadi Military Hospital
The results of this study showed that EP s and MRl
can provide a quantitative evaluation and be objective
measures in cases of BD with neurological involvement and
for early detection of the lesions.
The frequency of CNS involvement in our sample of
patients was six patients (30%), five of them (83.3%) had
abnormal MRI pattern, two had abnormal BAEPs (33.3%), two
had abnormal tibial nerve SEPs (33.3%) and three had
abnormal median neve SEP (50%).
Interestingly, MRl disclosed subclinical findings in
three patients out of the fourteen who were clinically
neurologically free (21.4%) indicating CNS alterations while
BAEPs were abnormal in six patients(42.8%), median as well
as tibial nerve SEPs separately were abnormal in only
two patients(14.4%).
In addition, combining the results ofEPs modalities
using (BAEPs and SEPs) showed abnormal results in all the six
patients with neuro-Behcet’s disease (I 00%) and in seven
patients who were clinically neurologically free (50%) with an
overall diagnostic sensitivity of 65%.
Moreover, combining EPs and MRl findings showed
that MR images were normal in eleven patients who were
clinically neurologically free, whereas EPs showed
abnormalities in five of them. On the other hand, EPs normal in one out of the eight patients who had visible MRl
abnormalities.
It is suggested -therefore- that BAEP & SEPs together
with MRI technique be applied to all patients with BD with or
without CNS disease as they are useful for quantitative
evaluation of neurological involvement and for assessment of
areas currently not optimally imaged by MRI. Consecutive
MRI studies are necessary to appreciate the effects of
treatment on abnormal imaging.
In addition, we recommend conducting a study of
brain magnetic stimulation to look for and evaluate central
motor conduction abnormalities and the degree of their
prevalence in patients with BD.