Epilepsy and Behcet's disease: Cortical and hippocampal involvement in Brazilian patients

Objective: To describe clinical, radiological and electrophysiological findings in epileptic neuro-Behcet's (NBD) patients. Methods: A retrospective review of 178 medical records of Behcet's disease patients was conducted in Brazil. Information on gender, ethnicity/skin color, age at symptom onset and age at onset of neurologic manifestations, type of seizures, clinical manifestation of the disease, use of antiepileptic drugs and immunosupressors was collected from medical records of all epileptic NBD patients. Brain MRI, cerebrospinal fluid (CSF) analysis and electroencephalograms (EEG) were assessed. Results: Forty NBD cases were identified, of which seven patients (17%) presented epilepsy. In five patients seizures occurred during an acute exacerbation of the disease, and in one patient they occurred six months after meningoencephalitis. One patient presented seizures in the progressive form of the disease and five patients had complex partial seizures. The EEG showed temporal involvement in three patients and frontal in one. Hippocampal lesions were identified in three patients and cortical lesions in five. All patients had good response to antiepileptic drugs and are seizure-free, except for one who developed refractory seizures. Conclusions: Brazilian NBD patients showed a high prevalence of epilepsy, mainly complex partial seizures, occurring at any phase of the disease. Epileptic NBD patients may have cortical and hippocampal lesions that could explain the occurrence of epilepsy. (C) 2011 Elsevier B.V. All rights reserved.