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一种不常见的疾病常被包括在神经疾病的鉴别诊断中:神经白塞综合征。

An uncommon disease included commonly in the differential diagnosis of neurological diseases: Neuro-Behçet's syndrome.

机构信息

Istanbul University Cerrahpaşa School of Medicine, Department of Neurology, Istanbul, Turkey.

Istanbul University Cerrahpaşa School of Medicine, Department of Neurology, Istanbul, Turkey.

出版信息

J Neurol Sci. 2021 Jul 15;426:117436. doi: 10.1016/j.jns.2021.117436. Epub 2021 Apr 20.

Abstract

Behçet's Syndrome (BS) may present with different neurological problems, related either directly (primary) or indirectly (secondary) to BS. Primary neurological involvement is named as neuro-Behcet's syndrome (NBS), and its two major subtypes that are classified mainly on the clinical and MRI findings are (1) Parenchymal-NBS (p-NBS) and (2) Extra parenchymal neuro-vascular involvement mostly seen as cerebral dural venous sinus thrombosis (CVST). The less commonly seen forms of NBS are cognitive and behavioral syndromes and peripheral nervous system involvement. Parenchymal-NBS is the most common clinical neurological presentation of BS. It is a rare disease with distinct MRI features and is often included in the differential diagnosis of neuro-vascular and neuro-inflammatory disorders. The most commonly affected neuro-anatomical site in p-NBS is the meso-diencephalic junction (MDJ), followed by the ponto-bulbar and thalamic regions, the basal ganglia, and the spinal cord. These varied locations may explain to a certain extent why BS is considered in the differential of so many neurological disorders. The other relatively common form of NBS that results in CVST may also be confused with other conditions resulting in CVST, especially when the systemic clinical features suggestive of BS are missed.

摘要

白塞病(BS)可能会出现不同的神经系统问题,这些问题与 BS 直接(原发性)或间接(继发性)相关。原发性神经系统受累被称为神经白塞病(NBS),根据主要基于临床和 MRI 发现的分类,其有两个主要亚型,即(1)实质型-NBS(p-NBS)和(2)以脑硬脑膜静脉窦血栓形成(CVST)为主的脑外血管神经受累。不那么常见的 NBS 形式是认知和行为综合征以及周围神经系统受累。p-NBS 是 BS 最常见的临床神经系统表现。它是一种罕见疾病,具有独特的 MRI 特征,通常被纳入神经血管和神经炎症性疾病的鉴别诊断中。p-NBS 中最常受累的神经解剖部位是中脑被盖交界处(MDJ),其次是桥脑-延髓和丘脑区域、基底节和脊髓。这些不同的部位在一定程度上可以解释为什么 BS 被认为是许多神经疾病的鉴别诊断之一。导致 CVST 的另一种相对常见的 NBS 形式也可能与其他导致 CVST 的疾病混淆,尤其是当 BS 的全身临床特征被遗漏时。

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