Clinical characteristics and course of spinal cord involvement in Behçet's disease

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<jats:p>Parenchymal neurological involvement in Behçet's disease (p‐NBD) usually presents with a brainstem syndrome; occasionally spinal cord may also be involved. Files of patients with Behçet's disease and spinal cord involvement were reviewed retrospectively, in comparison with other types of p‐NBD. Amongst 216 patients with p‐NBD, 24 had spinal cord involvement (11%). Most commonly patients presented with sensory‐motor symptoms, sphincter and/or sexual dysfunction evolving over days. Four of 10 patients showed single or multiple cervical and/or dorsal lesions on spinal MRI's and one showed dorsal atrophy. Although the clinical picture was variable, it tended to be severe; seven cases had primary progressive course, 11 cases had a secondary progressive course after initial attack(s), four had attacks with severe residual sequela and two had improvement after attacks. After a median follow‐up period of 67 months, eight were independent and 14 were dead or dependent, whereas amongst the remaining patients with p‐NBD, 113 patients were independent and 56 patients were dead or dependent (<jats:italic>P</jats:italic> < 0.05). Our study suggests that spinal cord involvement has even worse prognosis compared with other types of p‐NBD. Therefore, recognition of spinal cord involvement in Behçet's patients should prompt early vigorous treatment.</jats:p>

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