Longitudinally extensive transverse myelitis as the sole presentation of neuro-Behçet's disease responding to infliximab.

The Journal of Spinal Cord Medicine
Ian CoulterAnu Jacob

Abstract

Isolated involvement of the spinal cord is an uncommon presentation of neuro-Behçet's disease (NBD) and it is associated with a poor prognosis for functional recovery. A case report of an 18-year-old Turkish man who presented with a progressive paraparesis and bladder dysfunction secondary to a longitudinally extensive transverse myelitis as the sole presentation of NBD. Examination revealed a spastic paraparesis and a T7 sensory level. Magnetic resonance imaging revealed multiple enhancing lesions throughout the thoracic cord and cerebrospinal fluid showed intense neutrophilia. On further enquiry a family history of Behçet's disease was elicited. The patient subsequently reported a history of recurrent oral ulceration and intermittent occular inflammation. A diagnosis of NBD was made and intravenous high-dose steroids commenced with poor response. In view of the poor prognosis for functional recovery associated with spinal NBD the patient was treated with infliximab, an anti-tumour necrosis factor-alpha monoclonal antibody, leading to excellent recovery of function. Early treatment with infliximab may facilitate a favourable functional recovery and should be considered in cases of NBD with spinal cord involvement.

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Citations

Sep 9, 2015·Multiple Sclerosis and Related Disorders·Abdullah Al Sawaf, Joseph R Berger
Jan 24, 2015·The Journal of Spinal Cord Medicine·Devipriya RathnasabapathiAnu Jacob
Mar 29, 2014·The Journal of Spinal Cord Medicine·Uğur UygunoğluAksel Siva
Aug 29, 2013·Mediators of Inflammation·Daniel Sánchez-CanoNorberto Ortego-Centeno
Oct 21, 2015·Multiple Sclerosis : Clinical and Laboratory Research·Hyung Seok LeeSeung Min Kim
Jul 28, 2017·Annals of Neurology·Ugur UygunogluOrhun H Kantarci
May 24, 2018·Current Neurology and Neuroscience Reports·Uğur Uygunoğlu, Aksel Siva
Mar 13, 2021·Case Reports in Neurology·Shunya FujiwaraKoji Abe

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