Diagnosis and management of Neuro-Behçet's disease: international consensus recommendations

J Neurol. 2014 Sep;261(9):1662-76. doi: 10.1007/s00415-013-7209-3. Epub 2013 Dec 24.

Abstract

Neuro-Behçet's disease (NBD) is one of the more serious manifestations of Behçet's disease (BD), which is a relapsing inflammatory multisystem disease with an interesting epidemiology. Though NBD is relatively uncommon, being potentially treatable, neurologists need to consider it in the differential diagnosis of inflammatory, infective, or demyelinating CNS disorders. Evidence-based information on key issues of NBD diagnosis and management is scarce, and planning for such studies is challenging. We therefore initiated this project to develop expert consensus recommendations that might be helpful to neurologists and other clinicians, created through an extensive literature review and wide consultations with an international advisory panel, followed by a Delphi exercise. We agreed on consensus criteria for the diagnosis of NBD with two levels of certainty in addition to recommendations on when to consider NBD in a neurological patient, and on the use of various paraclinical tests. The management recommendations included treatment of the parenchymal NBD and cerebral venous thrombosis, the use of disease modifying therapies, prognostic factors, outcome measures, and headache in BD. Future studies are needed to validate the proposed criteria and provide evidence-based treatments.

Publication types

  • Review

MeSH terms

  • Behcet Syndrome / complications
  • Behcet Syndrome / diagnosis*
  • Behcet Syndrome / therapy*
  • Consensus*
  • Diagnosis, Differential
  • Evidence-Based Practice / trends
  • Humans
  • Intracranial Thrombosis / etiology
  • Intracranial Thrombosis / therapy
  • Venous Thrombosis / etiology
  • Venous Thrombosis / therapy