Immune-mediated conditions affecting the brain, eye and ear (BEE syndromes)

J Neurol Neurosurg Psychiatry. 2019 Aug;90(8):882-894. doi: 10.1136/jnnp-2018-319002. Epub 2019 Mar 9.

Abstract

The triad of central nervous system symptoms, visual disturbance and hearing impairment is an oft-encountered clinical scenario. A number of immune-mediated diseases should be considered among the differential diagnoses including: Susac syndrome, Cogan syndrome or Vogt-Koyanagi-Harada disease; demyelinating conditions such as multiple sclerosis or neuromyelitis optica spectrum disorder; systemic diseases such as systemic lupus erythematosus, Sjögren syndrome or Behcet disease and granulomatous diseases such as sarcoidosis. In this article, we coin the term 'BEE syndromes' to draw attention to the various immune-mediated diseases that affect the brain, eye and ear. We present common disease manifestations and identify key clinical and investigation features.

Keywords: Behcet; Cogan; Sjögren; Susac; Vogt koyanagi harada.

Publication types

  • Review

MeSH terms

  • Brain Diseases / etiology*
  • Brain Diseases / immunology
  • Ear Diseases / etiology*
  • Ear Diseases / immunology
  • Eye Diseases / etiology*
  • Eye Diseases / immunology
  • Humans
  • Immune System Diseases / complications*
  • Syndrome