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The following is a summary of “Clinical and imaging features of parenchymal and non-parenchymal neuro-Behçet’s disease: a systematic review of case reports and series,” published in the May 2025 issue of BMC Neurology by Al-omoush et al. 

Early-stage symptoms and imaging features of Neuro-Behçet’s Disease (NBD) were poorly characterized despite known MRI and cerebrospinal fluid abnormalities.  

Researchers conducted a retrospective study to examine clinical and imaging features of newly diagnosed parenchymal and non-parenchyma NBD using case reports and series.  

They synthesized case reports and series from MEDLINE, Scopus, EMBASE, PubMed, Web of Science, and Cochrane Library up to October 17th, 2023. Adult patients (≥ 18 years) with confirmed parenchymal or non-parenchymal NBD based on neurological symptoms linked to Behçet’s disease were included. Studies required MRI evidence of central or peripheral nervous system involvement. Statistical analyses included chi-square and Mann-Whitney tests with 95% CIs. The study protocol was registered with PROSPERO (ID: CRD42023472436).  

The results showed that among 174 patients from 107 case reports and a case series, patients with parenchymal NBD (n = 141; mean age 35.54 ± 13.33 years) commonly had ocular symptoms (80.9%), pyramidal signs (57.5%), cranial nerve palsies (50.4%), and headache (32.6%). Patients with non-parenchymal (n = 19; mean age 28.68 ± 10.67 years) frequently presented with headaches (86.4%), papilledema (47.4%), cranial nerve palsies (42.1%), and nausea (31.6%). The mixed-type group (n = 14; mean age 27.5 ± 11.57 years) often showed headaches (64.3%), pyramidal signs (50%), fever (50%), and diplopia (35.7%). Brainstem involvement predominated in both acute and chronic parenchymal cases, with contrast enhancement significantly higher in acute than in chronic progressive NBD.  

Investigators concluded that recognizing distinct clinical patterns in parenchymal and non-parenchymal NBD aids in earlier diagnosis and treatment. 

Source: bmcneurol.biomedcentral.com/articles/10.1186/s12883-025-04250-0