Neurological disorder | Imaging appearances | CSF findings | Treatment | |
Meningoencephalitis | Brain Brainstem Cord | Lesions with enhancement | Active, leucocytosis OB rarely present | Intravenous corticosteroid Immediate institution or escalation of immunosuppressive therapy |
Chronic progressive disease | Atrophy without enhancement | Less active, IL-6 elevated | Corticosteroid and immunosuppression Role of TNFα antagonists to be defined | |
Venous disease | CVST Intracranial hypertension | Venous sinus thrombosis Normal | Normal Normal | Intravenous corticosteroid Immediate institution or escalation of immunosuppressive therapy Role of TNFα antagonists to be defined Corticosteroid and immunosuppression Diuretic therapy |
Arterial disease | Cerebral infarction Cerebral haemorrhage Aneurysm | Infarction Haemorrhage within a lesion Subarachnoid or parenchymal Beading or occlusion on angiography On MRA; may be multiple | Intravenous corticosteroid Immediate institution or escalation of immunosuppressive therapy TNFα antagonist immediately Role of IL-6 antagonists to be defined | |
Perfusion disorder | Regional perfusion defects on SPECT and PET | Pathogenesis and treatment to be defined | ||
Cranial neuropathy | Optic nerve Others Vestibulocochlear | Lesion in nerve or sheath Lesion in brainstem, meningeal enhancement or normal Normal | Corticosteroid and immunosuppression | |
Movement disorders and epilepsy | Associated brainstem and/or cerebral lesion | Treatment of the meningoencephalitis | ||
Cognitive and psychiatric disorders | Normal or lesion in brainstem | Careful multidisciplinary assessment to define relationship to Behçet’s syndrome Treatment of meningoencephalitis Treatment of systemic disease without brain disorder Treatment of underlying psychiatric disorder | ||
Peripheral neuropathy Myositis | Corticosteroid and immunosuppression Corticosteroid and immunosuppression |