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Letters   |    
Behavioral and Cognitive Impairments as Presenting Features of Behçet's Disease
Rajeet Shrestha, M.D.; Ayesha Erfan, M.D.
The Journal of Neuropsychiatry and Clinical Neurosciences 2013;25:E05-E07. doi:10.1176/appi.neuropsych.12080207
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Northcoast Behavioral Healthcare
Northfield, OH

Correspondence: Dr. Shrestha; e-mail: rajeetshrestha@gmail.com

Copyright © 2013 by the American Psychiatric Association

Extract

To the Editor: Behçet's disease (BD) is an inflammatory disease of unknown etiology characterized by relapsing episodes of oral aphthous ulcers, genital ulcers, uveitis, and skin lesions. Other systems, including vascular, gastrointestinal, and CNS can also be involved. It is most commonly seen in the Mediterranean, Middle East, and Far East regions.1,2 The diagnosis is clinical, based on International Study Group (ISG) of Behçet's Disease criteria.3 It is rare in the United States, with prevalence rates estimated to be 0.12 to 0.33 per 100,000.1 Various studies have found neurological involvement in 1.3% to 59% of cases.47 Two main categories of CNS involvement are described: parenchymal, which mostly manifests as subacute meningoencephalitis; and nonparenchymal, which mainly involves the cerebral vascular structures. Cognitive and behavioral symptoms can occur with or without overt CNS involvement.810 We present a case of diagnosis of BD in a patient who initially presented to psychiatric care with neuropsychiatric symptoms without significant neurological signs or symptoms.

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