Neuro-Ophthalmologic Manifestations of Behcet's Disease

Abstract

Eighty of 300 patients with Behcet's disease presenting with neurological complications were reviewed. Neuro-ophthalmological signs were present in 14% of all patients with Behcet's disease. Oculomotor findings were sixth nerve palsy in eight, third nerve palsy in two and supranuclear gaze disorders in two patients. These are explained on the basis of increased intracranial pressure or brainstem infarction. Twenty-five of 80 patients had papilledema and increased intracranial pressure. The high incidence of papilledema due to intracranial hypertension and dural vein thrombosis is emphasized. Plasma prostacyclin (PGI₂) and vessel wall in vitro PGI₂ biosynthesis were found to be significantly decreased compared to normals in all three patients studied. Three patients presented with optic neuropathy. Progressive atrophy of the optic disc and severe visual loss is not uncommon in Behcet's disease, however, visual loss due to acute optic neuropathy is rare. The authors believe that the pathogenesis could be explained by the occlusion of the small vessels of the optic nerves due to vasculitis and demyelinization on the basis of mild ischemia.

Key Words:

• Behçet's disease
• papilledema
• optic neuropathy
• pseudotumor cerebri
• oculomotor disorders