Kale Nilufer, Agaoglu Jale, Icen Murat, Yazici Isil, Tanik Osman
Department of Neurology, Mayo Clinic College of Medicine, Rochester, MN, USA.
Headache. 2009 Mar;49(3):467-70. doi: 10.1111/j.1526-4610.2008.01265.x.
Behçet's disease (BD) is a chronic, relapsing, multisystemic, inflammatory disorder with unknown etiology. Neurological involvement is observed in about 5% of the patients with BD and headache is a frequently reported symptom with or without neurological involvement. In this case-series, we aim to demonstrate the secondary headaches associated with neuro-Behçet's disease in consecutive BD patients who had been referred for neurologic evaluation.
The case-series included 17 patients (11 males [65%]), mean age 41 +/- 11.4, who met the criteria for BD established by the International Study Group for BD and developed headache during the disease course.
Seventeen BD patients were identified, the neurologic presentations included in parenchymal involvement 12 (70%), extraparenchymal involvement/venous thrombosis in 5 (30%), seizure disorder in 2 (12%), and psychiatric problems/depression or anxiety in 5 (30%) patients, respectively. The characteristics of the headache according to the patients' reports included subacute, moderate to severe headache with unilateral localization and throbbing quality accompanied by nausea, vomiting, and aggravation upon awakening.
Because neurological involvement is one of the most devastating aspects of BD, the need to treat neurological involvement as early as possible, the possible role of headache onset as an early indicator for neurological involvement in this relatively uncommon disease should be kept in mind.
白塞病(BD)是一种病因不明的慢性、复发性、多系统炎症性疾病。约5%的BD患者会出现神经受累,无论是否有神经受累,头痛都是常见症状。在本病例系列中,我们旨在展示在因神经科评估而转诊的连续性BD患者中与神经白塞病相关的继发性头痛。
该病例系列包括17例患者(11例男性[65%]),平均年龄41±11.4岁,符合国际白塞病研究组制定的BD标准且在病程中出现头痛。
共确定17例BD患者,神经表现包括实质受累12例(70%)、脑外受累/静脉血栓形成5例(30%)、癫痫发作2例(12%)以及精神问题/抑郁或焦虑5例(30%)。根据患者报告,头痛特点包括亚急性、中度至重度头痛,单侧定位,搏动性,伴有恶心、呕吐,晨起时加重。
由于神经受累是BD最具破坏性方面之一,应牢记尽早治疗神经受累的必要性,在这种相对罕见的疾病中,头痛发作作为神经受累早期指标的可能作用。