Transcranial magnetic stimulation in Behçet's disease: a cross-sectional and longitudinal study with 44 patients comparing clinical, neuroradiological, somatosensory and brain-stem auditory evoked potential findings.
OBJECTIVE
To compare neurological involvement in Behçet's disease as documented by transcranial magnetic stimulation (TMS) with clinical, neuroradiological, somatosensory (SEP) and auditory evoked potential (BAEP) findings.


METHODS
Forty-four patients were studied over an 8 year period. Nine patients had follow-up studies done. TMS central motor conduction (CMC) studies to upper and lower limb muscles, brain magnetic resonance imaging (MRI), SEP, and BAEP testing were conducted.


RESULTS
Thirty-nine patients had CMC slowing, decreased amplitude or absent motor evoked potentials (MEP); 5 of these patients were neurologically normal. Concordance of TMS results, clinical deficits, and MRI findings occurred in 36 of the 39 patients. SEP and BAEP testing proved non-complementary to MEP. Generally, follow-up studies revealed faster CMC and higher MEP amplitude. However, in two patients the CMC time to one target muscle became prolonged with diminished MEP amplitude over a period of 1.5-3 years.


CONCLUSIONS
TMS can be useful in detecting and quantifying motor tract dysfunction in Behçet's disease and provides functional information complementary to imaging studies. TMS is more sensitive than either SEP or BAEP. Our longitudinal studies suggest that TMS studies may be valuable in monitoring disease activity or therapeutic response.
Stigsby
B
B
Section of Neurophysiology, Department of Neurosciences, King Faisal Specialist Hospital and Research Centre, 11211, Riyadh, Saudi Arabia. bent_stigsby@hotmail.com
Bohlega
S
S
McLean
D R
DR
Al-Kawi
M Z
MZ
D000293:Adolescent; D000328:Adult; D001528:Behcet Syndrome / Q000175:diagnosis / Q000503:physiopathology*; D001921:Brain / Q000473:pathology / Q000503:physiopathology; D003430:Cross-Sectional Studies; D004558:Electric Stimulation / Q000295:instrumentation; D016057:Evoked Potentials, Auditory, Brain Stem; D019054:Evoked Potentials, Motor; D005073:Evoked Potentials, Somatosensory; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D020127:Recovery of Function; D012008:Recurrence; D050781:Transcranial Magnetic Stimulation