A Complex Case of Neuro-Behçet's Disease in a Patient Previously Diagnosed with multiple Sclerosis: A Case Report

Abstract

Multiple sclerosis (MS) and Neuro-Behçet's disease (NBD) have been associated with a range of neuropsychiatric symptoms, including fatigue, cognitive impairment, depression, bipolar disorder, anxiety, sexual dysfunction, and other behavioral disturbances that are characterized by remissions and exacerbations at different points during the course of the disease. We present an interesting case of NBD in a 48-year-old female who had previously been diagnosed with MS. Exploration of this patient's various neuropsychiatric symptoms, their misattribution first to psychopathology and then subsequently to a variety of neurological problems exemplifies the potential pitfalls in diagnosis of a seemingly rare disorder. The role of psychosocial stress-related inflammatory changes in the patient's behavioral and neurological symptoms is explored as well as the potential psychological and medical effects of delayed diagnosis and treatment.

Behçet’s Disease Is Associated with Multiple Sclerosis and Rheumatoid Arthritis: A Korean Population-Based Study

“…Although inflammatory bowel disease as a comorbidity is suggested to be increased in patients with BD, the association of rheumatoid arthritis and multiple sclerosis with BD has not been previously reported. Some neuro-BD patients are reported to have clinical and laboratory features resembling multiple sclerosis rather than neuro-BD [23][24][25]. Neuro-BD mimics multiple sclerosis in some aspects, including a high occurrence in young individuals, a relapsing-remitting or progressive course, the perivascular infiltration of inflammatory cells, hyperintense lesions on T2-weighted magnetic resonance imaging (MRI), abnormal evoked potentials, and a treatment response to corticosteroids and immu-nosuppressant drugs [25].…”