A case of neuro-Behcet's disease presenting with lumbar spinal cord involvement

Abstract

Case report. To report an unusual case of neuro-Behcet's disease (NBD) presenting with isolated myelitis that affected the lumbar cord. Department of Neurology, West China Hospital, Chengdu, Sichuan, China. 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. 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. 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.