B Zhao1, L He, X-H Lai. 1. Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China.
Abstract
STUDY DESIGN: Case report. OBJECTIVES: To report an unusual case of neuro-Behcet's disease (NBD) presenting with isolated myelitis that affected the lumbar cord. SETTING: Department of Neurology, West China Hospital, Chengdu, Sichuan, China. METHODS: A 19-year-old man presented with a 3-day history of paresthesia and weakness in both the legs. He had a 6-year history of recurrent oral and genital ulcers with erythema nodosum on his legs. Magnetic resonance imaging (MRI) revealed a T1-hypointense and T2-hyperintense lesion at the L1 level. Nodular enhancement of the lesion was achieved with gadolinium administration. Biopsy specimens from cutaneous lesions were consistent with an active perivasculitic process. RESULTS: Corticosteroid (pulsed methylprednisolone followed by oral prednisolone) therapy was administered immediately. Subsequently, the patient's clinical condition improved dramatically. The spinal cord lesion disappeared on the MRI performed 1 year later. Thus far, there has been no recurrence. CONCLUSION: NBD may involve the lumbar spinal cord. Prompt recognition of this disease and early vigorous steroid therapy are important to prevent further disability and recurrence.
STUDY DESIGN: Case report. OBJECTIVES: To report an unusual case of neuro-Behcet's disease (NBD) presenting with isolated myelitis that affected the lumbar cord. SETTING: Department of Neurology, West China Hospital, Chengdu, Sichuan, China. METHODS: A 19-year-old man presented with a 3-day history of paresthesia and weakness in both the legs. He had a 6-year history of recurrent oral and genital ulcers with erythema nodosum on his legs. Magnetic resonance imaging (MRI) revealed a T1-hypointense and T2-hyperintense lesion at the L1 level. Nodular enhancement of the lesion was achieved with gadolinium administration. Biopsy specimens from cutaneous lesions were consistent with an active perivasculitic process. RESULTS: Corticosteroid (pulsed methylprednisolone followed by oral prednisolone) therapy was administered immediately. Subsequently, the patient's clinical condition improved dramatically. The spinal cord lesion disappeared on the MRI performed 1 year later. Thus far, there has been no recurrence. CONCLUSION: NBD may involve the lumbar spinal cord. Prompt recognition of this disease and early vigorous steroid therapy are important to prevent further disability and recurrence.