A 58-year-old man with a history of recurrent aphthous ulcers since childhood was admitted to the hospital with acute neurological decline characterised by loss of motor dexterity, dysarthria, dysphagia and unsteady gait. MRI brain was significant for symmetrical hyperintense T2 fluid attenuated inversion recovery (FLAIR) in the corticospinal tracts, including parts of the pons and the mesodiencephalic junction. Though initial concern was for neuro-Behçet’s disease, brain biopsy ultimately revealed a diagnosis of astrocytoma. This report demonstrates a mimic of neuro-Behçet’s disease and the importance of confirming the correct diagnosis prior to initiating therapy.
- brain stem / cerebellum
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Contributors JM provided the first draft and several subsequent drafts of the report. JH assisted in generating draft versions—including the figure—in respect to the neurological and neuroanatomical contents of the manuscript. JN supervised JM’s and JH’s writing, edited and revised all manuscript draft versions, rewrote and added sections of the paper.
Funding This study was funded by NIH (K08EY025324).
Competing interests None declared.
Patient consent Next of kin consent obtained.
Provenance and peer review Not commissioned; externally peer reviewed.