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Neuro-Behçet's Disease — RACP Adult Medicine MCQ

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HardDermatologyNeuro-Behçet's DiseaseRACP Adult Medicine

A 45-year-old woman presents with recurrent painful oral ulcers. She also has vulvar ulcers and bilateral anterior uveitis. Pathergy test is positive. She develops sudden onset severe headache with CSF showing lymphocytic pleocytosis and elevated protein. MRI brain is normal. What neurological complication has occurred?

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Correct answer: E — Aseptic meningitis (neuro-Behçet's)

Neuro-Behçet's disease can present as aseptic meningitis with CSF lymphocytic pleocytosis and elevated protein. Parenchymal disease (brainstem lesions) and dural venous sinus thrombosis are other CNS manifestations. Treatment involves high-dose corticosteroids and azathioprine or infliximab for maintenance. MRI brain may be normal in meningeal forms. The CSF is inflammatory but sterile, distinguishing it from bacterial meningitis.

Reference: eTG – 2025 – Rheumatology; EULAR – 2018 – Behçet's Disease Management Recommendations