López Bravo Alba, Parra Soto Carlos, Bellosta Diago Elena, Cecilio Irazola Álvaro, Santos-Lasaosa Sonia
Servicio de Neurología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España.
Servicio de Medicina Física y Rehabilitación, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España.
Reumatol Clin (Engl Ed). 2019 Sep-Oct;15(5):e36-e38. doi: 10.1016/j.reuma.2017.04.009. Epub 2017 May 22.
Neurological involvement in Behçet's disease is rare, especially at the onset. It can present in the form of parenchymal changes or as damage to the vascular structures in its nonparenchymal form. The coexistence of both kinds of manifestations in the same patient is exceptional. We report the case of a 32-year-old patient with a history of deep venous thrombosis, who was being treated for holocranial headache, apathy, and oral and genital ulcers. Brain magnetic resonance imaging showed hyperintense lesions in the basal ganglia and white matter, and the vascular study evidenced venous thrombosis of the left transverse sinus. After confirming the diagnosis of Behçet's disease with parenchymal and nonparenchymal cerebral involvement, immunosuppressive and corticosteroid therapy was started, resulting in the remission of the symptoms.
白塞病累及神经系统较为罕见，尤其是在疾病初发时。其可表现为实质改变，或以非实质形式损害血管结构。同一患者同时出现这两种表现的情况极为罕见。我们报告一例32岁有深静脉血栓形成病史的患者，该患者因全头痛、淡漠以及口腔和生殖器溃疡正在接受治疗。脑部磁共振成像显示基底节和白质有高信号病变，血管检查证实左侧横窦静脉血栓形成。在确诊为伴有脑实质和非脑实质受累的白塞病后，开始进行免疫抑制和皮质类固醇治疗，症状得以缓解。
