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• Vol.58 No.2
• CLINICA NEUROL, 58: 105−110, 2018
• Vol.58 No.2 contents

Case Report

A case of chronic progressive neuro-Behcet's disease with cerebellar ataxia and bulbar palsy preceding mucocutaneo-ocular symptoms

Masashi Watanabe, M.D.¹⁾³⁾, Rei Kobayashi, M.D., Ph.D.¹⁾, Takakazu Hasegawa, M.D.²⁾, Shunsuke Yokoi, M.D.²⁾, Hisashi Okada, M.D., Ph.D.¹⁾ and Satoshi Okuda, M.D., Ph.D.¹⁾

¹⁾Department of Neurology, National Hospital Organization Nagoya Medical Center
²⁾Department of Rheumatology and Clinical Immunology, National Hospital Organization Nagoya Medical Center
³⁾Present address: Department of Neurology, Ehime Prefectural Central Hospital

A 77-year-old man with a history of cigarette smoking had suffered from vertigo and depression repeatedly for twelve years. He gradually developed bradykinesia in the past half decade and fell down 3 times in the last half year. On admission, he presented with cerebellar ataxia and bulbar symptoms. Brain MRI showed atrophy in the cerebellum and brainstem. ¹²³I-IMP SPECT showed hypoperfusion bilaterally in the cerebellum. Blood examinations showed various elevated inflammatory values and positive for HLA-B51. Cerebrospinal fluid (CSF) revealed aseptic meningitis and increased IL-6 levels. Therefore, we strongly suspected that he had chronic progressive neuro-Behcet's disease (CPNBD), clinically. Systemic mucocutaneous symptoms appeared 1 month after starting treatments. Pathological findings of his skin biopsy were consistent with Behcet's disease. It should be kept in mind that both positive HLA-B51 and increased CSF IL-6 levels have the possibility of containing important clues in the diagnosis of CPNBD.
Full Text of this Article in Japanese PDF (823K)

(CLINICA NEUROL, 58: 105−110, 2018)
key words: chronic progressive neuro-Behcet's disease, cerebellar ataxia, HLA-B51, cerebrospinal fluid IL-6, ¹²³I-IMP SPECT

(Received: 15-Aug-17)