Peripheral nerves’ affection in Behçet’s disease and its relation to disease duration and activity

Abstract

Background Behçet’s disease (BD) is a chronic vascular-inflammatory disease with unknown etiology that involves principally oral and genital mucosa, skin, and eyes. Central nervous system involvement is common in BD, but peripheral nerve involvement is uncommon. Objective To determine peripheral nerve involvement and study its relation to disease duration and activity. Participants and methods In this case–control study, a total of 30 patients with clinically established BD according to International Criteria for Behçet’s Disease and 30 healthy asymptomatic individuals matched for age and sex with the patient group were recruited. All patients in this study had been subjected to a full assessment of medical history, full medical examination, the BD current activity score form and the neuropathy symptom score, along with electrophysiological nerve conduction studies including sensory and motor nerve conduction assessments and laboratory investigations. Results Based on the electrophysiological studies, 16 (53.3%) patients had evidence of peripheral neuropathy (PN). Of these, five (15.6%), six (20%), and six (20%) patients had median, ulnar, and tibial nerve affection, respectively. Consequently, nine (30%) patients had peroneal nerve affection and 14 (46.7%) patients had sural nerve affection. It is noteworthy that the most affected nerve in our study was the sural nerve, and approximately half of the included patients showed electrophysiological evidence of affection. We also found a correlation between incidences of peripheral neuropathy in patients with high BD current activity score form scores and a long duration of symptoms. We observed a significant increase in inflammatory markers (erythrocyte sedimentation rate and C-reactive protein) and liver enzymes (alanine aminotransferase and aspartate aminotransferase) in the BD group compared with the control group. Conclusion The prevalence of peripheral nerve involvement in BD was 53.3%. Lower extremity sensory nerves were affected more prominently than upper and motor nerves. The longer the disease duration, the more the effects on the peripheral nerves. There is a positive correlation between aging or disease activity and the occurrence of peripheral neuropathy in BD.