TY - JOUR T1 - CEREBROVASCULAR EVENTS UNMASKING A RARE BUT TREATABLE DISEASE JF - Journal of Neurology, Neurosurgery & Psychiatry JO - J Neurol Neurosurg Psychiatry SP - A21 LP - A22 DO - 10.1136/jnnp-2012-304200a.81 VL - 83 IS - Suppl 2 AU - L Zhang AU - DC Paviour AU - U Khan Y1 - 2012/11/01 UR - http://jnnp.bmj.com/content/83/Suppl_2/A21.3.abstract N2 - Behcet's disease is a systemic vasculitis with an unknown etiology. Central nervous system involvement occurs in 5–10% of cases. We report two cases with different neurological presentations. Case 1 A 26-year-old man, presented with sudden onset of head and neck pain, unsteady gait, and a right hemiparesis with sensory loss. MRI showed swelling of the left side of the Pons and midbrain. DW-MRI showed intermediate high signal, suggesting a vascular event. He was treated with anti-platelets and made a full recovery. MRI at 4 months showed signal abnormality consistent with haemosiderin. He represented 18 months later with an acute onset headache, diplopia, dysarthria and ataxia. MRI showed brainstem swelling and a small hemorrhage in the Pons. A review revealed a history of genital ulceration and the presence of a mouth ulcer. Case 2 A 26-year-old man, presented with a headache worsening over 6 months with 2 weeks of blurred vision. He had been taking tetracycline for acne for 2 years. He had papilloedema and bilateral VI nerve palsies. After an unremarkable MRI, a lumbar puncture (LP) confirmed intracranial hypertension with normal csf. Tetracycline was stopped. His headache returned a month later. Questioning revealed an episode of painless loss of vision in his right eye as a teenager. Examination revealed new mouth and genital ulcers. A repeat MRI revealed cerebral venous sinus thrombosis. Behcet's is a rare condition. In both cases phenotypic features of the disease had been present but their significance missed until the patients presented with neurological symptoms. ER -