Abstract text (incl. figure legends and references)

Introduction

Behçet"s disease (BD) is a relapsing multisystem inflammatory condition. It manifests as recurrent oral and genital aphthous ulceration, skin lesions, ocular disease (uveitis), arthritis and neurological deficits.

Neuro-Behçet"s Disease (NBD) affects avout 10% of patients and can be associated with high morbidity and mortality and is classified into parenchymal (brainstem, multifocal, myelopathy, cerebral or optic neuropathy), and non-parenchymal (cerebral venous thrombosis, intracranial hypertension, acute meningeal syndromes) disease

Objectives

To evaluate patients seen in the NBC at the national Behçet"s centre in Liverpool, UK.

Methods

A prospective review of all patients in the NBC from December 2021 to June 2022.

Results

24 patients (10%, F: 19, M:5) were seen in the NBD clinic, of the total of 249 patients. 4 patients (2%) fulfilled the criteria for NBD, 3 of which had parenchymal disease, 1 with inflammatory cerebellar lesions, 1 with an inflammatory CSF but normal imaging and one with optic neuropathy. One patient had non-parenchymal disease with cerebral sinus venous thrombosis (CSVT).

20 (83%) patients presented with migraine, 15 (75%) of whom had associated medication overuse headaches (MOH). Only 13 patients had received prior preventatives.

18 (75%) patients were already on immunosuppression initiated and 1 patient was started on immunosuppression following the diagnosis of CSVT.

Conclusion

Based on our findings, NBD remains a rare complication of BD (2%) with majority of patients seen in the NBC presenting with migraine (83%); only 65% (13) of whom had received on average 2 prior preventative treatment (Propranolol, 5 and Pregabalin, 6). MOH is a common co-morbid condition. Given the prevalence of migraine in the general population, further studies would be required to ascertain the correlation to BD.

Other complications of NBD were much rarer but associated with significant morbidity.