J Korean Med Sci.  2010 Jan;25(1):185-187. 10.3346/jkms.2010.25.1.185.

A Case of Recurrent Neuro-Behcet's Disease after Tooth Extraction

• Choi SM
• Choi YJ
• Kim JT
• Lee SH
• Park MS
• Kim BC
• Kim MK
• Cho KH

• KMID: 1713856
• DOI: http://doi.org/10.3346/jkms.2010.25.1.185

Abstract

We report a 39-yr-old man with neuro-Behcet's disease (NBD) in remission who developed left-sided ataxia with a sensory deficit about 10 days after tooth extraction. Several years ago, he experienced a similar episode of relapse after tooth extraction. Brain magnetic resonance imaging showed a newly developed right thalamic lesion. In cerebrospinal fluid, lymphocyte-dominant pleocytosis and mild elevation of IgG were found. Immunologic factors may be important in the pathogenesis of NBD because of the time delay between tooth extraction and relapse. Careful observation and prevention are needed before dental procedures in patients with NBD.

Keyword

Neuro-Behcet's Disease; Tooth Extraction; Recurrence

MeSH Terms

Adult
Behcet Syndrome/*diagnosis/drug therapy
Brain/radionuclide imaging
Humans
Immunoglobulin G/analysis
Leukocytosis/cerebrospinal fluid/diagnosis
Magnetic Resonance Imaging
Male
Methylprednisolone/therapeutic use
Neuroprotective Agents/therapeutic use
Recurrence
*Tooth Extraction
Immunoglobulin G
Neuroprotective Agents
Methylprednisolone

Figure

• 

  Fig. 1 Brain MRI of the patient. T2-weighted images (A) show ovoid, bright high signal lesions (white arrows) in the right thalamus. The same lesions are shown on FLAIR images (B) and diffusion-weighted images (C). T2-weighted images taken 6 yr prior to this presentation (D) show high signal lesions in both thalami and their adjacent areas.

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