All the patients with severe disability had parenchymal involvement, as seenon brain MRI, and pyramidal signs
on examination (Table 2).
The symptoms and signs of sympathetic hyperactivity (such as evening pyrexia, hypertension, increased sweating and tearing, tachycardia/tachypnea, and impotence) and somatomotor abnormalities (including pyramidal signs
, myoclonus, dysarthria/dysphagia, and gait dysfunctions) occur with variable latency and worsen progressively.
The asymmetric sensory-motor involvement, pyramidal signs
, and lumbosacral skin lesion were thought to be caused by the multiradicular effects of syringomyelia involving the dorsal root ganglion at the lumbosacral level.
In addition, they all had pyramidal signs
, rhinolalia, and Babinski's sign.
Clearly, several other disease processes can produce long tract or pyramidal signs
such as multiple sclerosis, myelitis, and stroke.
Other minor overlapping manifestations include pyramidal signs
, psychiatric disorders, sensory changes, and pain .
However, there were no consciousness disturbance or pyramidal signs
found in our patient which made a differential diagnosis with BBE.2 Although the patient have cerebrovascular risk factors, such as age older than 65, hypertension and diabetes mellitus, brain stem infarction can be excluded by the absence of the infarction related symptoms and the brain MRI.
Signs include high-stepping gait associated with bilateral foot drop and, in severe cases, quadriplegia with foot and wrist drop as well as pyramidal signs
Finally, pyramidal signs
and mental impairment were less observed in Asians in both classic and atypical groups (P < 0.05).
Reflexes were all present, without pyramidal signs
. No abnormalities were found by medullar magnetic resonance imaging.
Approximately 5% of patients with Behcet's disease have neurological involvement, out of which, 80 % have parenchymal involvement with pyramidal signs
and symptoms and approximately 20% cases can have dural sinus thrombosis.
Approximately 74% of patients exhibit autonomic failure, 87% experience Parkinsonism, 54% experience cerebellar ataxia, and 49% exhibit pyramidal signs
such as paralysis, muscle weakness, loss of muscle control, and tremor.