Isolated sixth nerve palsy as a presentation of neuro-Behçet’s disease

Authors

  • Faris M. Al Ghulaiga Department of Ophthalmology, College of Medicine, King Saud University, Saudi Arabia
  • MD, Daniah Al-showaeir MD, PhD, Assistant Professor, Ophthalmology Department, College of Medicine, King Saud University, PO Box 245, 11411 Riyadh, KSA, Tel: 00966 554400977
  • MD, Bushra Adel Kokandi Department of Ophthalmology, College of Medicine, King Saud University, Saudi Arabia
  • MD, Abdulrahman Al Harbi Department of Medical Imaging, King Abdulaziz Medical City, Saudi Arabia

DOI:

https://doi.org/10.3941/jrcr.5310

Abstract

Introduction: This study aims to report a case of neuro-Behçet’s disease (NBD) presenting as isolated sixth nerve palsy in a patient with a history of inactive ocular Behçet’s disease (BD), emphasizing the need for understanding diverse NBD manifestations. Case Report: it is an observational case report. A 21-year-old BD patient, non-compliant with medications, presented with fever, headache, and double vision. Clinical, laboratory, and radiological assessments, including CT, MRI, and lumbar puncture, were conducted to diagnose and characterize NBD. Treatment involved prednisolone, azathioprine, and adalimumab. Neurological examination revealed sixth nerve palsy, supported by imaging findings indicative of vasculitis in the brainstem—a unique radiological presentation in the literature. Treatment led to symptom resolution in a 6-month follow-up. Conclusion: This case reveals the diverse spectrum of NBD presentations, highlighting the importance of treatment compliance and contributing to a deeper understanding of the disease for refining therapeutic approaches.

Eye movements in nine cardinal positions of gaze demonstrating a right esotropia in the primary position and a limitation of abduction in the right gaze.

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Published

2024-09-18

Issue

Vol. 18 No. 8 (2024)

Section

Neuroradiology

License

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