AB1407-HPR NEUROLOGICAL MANIFESTATIONS DURING THE BEHCET DISEASE. (June 2019) - Wafa, Skouri
Abstract : Background: behcet disease MB is a systemic inflammatory disease whose common histopathological substratum is a vasculitis that can reach all vessels. Neurological impairment is one of the diagnostic criteria for MB. A serious condition affects the functional and vital prognosis. Objectives: The aim of our work was to study the epidemiological, clinical, therapeutic and evolutionary characteristics of patients with BD with neurological involvement. Methods: This was a retrospective, monocentric, descriptive study of NB from the adult population collected from a population of 150 patients monitored for MB. The study was conducted in the Neurology and Internal Medicine departments over a period of 19 years, from January 1997 to December 2015. Patients meeting the criteria of the international Study Group of the MB of 1990, those of the criteria of the International Criteria for Behcet Disease (ICBD) and the diagnostic criteria of Neuro-behcet defined proposed by the international consensus of experts of 2014. Results: We collect 35 patients. The gender ration was at 6 with 30 men for 5 women. The mean age of our population was 34+- 1.92 years. The neurological manifestations had inaugurated the MB in 55% of the cases. Ninety-four percent of patients had central nervous system involvement, while two patients had peripheral polyradiculoneuritis. Central involvement was parenchymal in 85% of cases, nonparenchymatous in 3% of cases and lixed in 6% of cases. Cerebral imaging showed predominant demyelinating lesions in periventricular and brain stem in 15 patients, a peudo-tumor appearance in 3 patients, and vascular lesions with arterial aneurysm and cerebral thrombophlebitis in 2 patients. Therapeutically, all patients received corticosteroid therapy with immunosuppressive therapy for 15 patients. Three patients had received an immunomodulatory treatment of anti-TNF a Type. The evolution was by push in 60% of cases, primary progressive in 20% of cases and secondarily progressive in the rest of the cases. Three-quarters of patients with parenchymal brain injury had a favorable outcome. The Outcome was unfavorable in all patients with diffuse disease, brain stem damage, spinal cord injury, angio-behavior, polyradiculoneuropathy and mixed impairment. The change in visual impairment (NORB) was favorable in one case in two. Conclusion: Neurological manifestations of MB are serious complications, and are typically poor prognosis both on a vital and functional level. Mortality remains high and neurological sequelae (motor and neuropsychological) are heavy. The prognosis in all the worse because the treatment is instituted late, hence the interest of an early and well conducted treatment Disclosure of Interests: None declared