Nörobehçet tanısı ile takip edilen 31 yaşında kadın hasta, denge kaybı ve başdönmesi yakınması ve duygurudum labilitesi ile polikliniğe başvurmuştur. Intravenöz steroidinin dördüncü gününde, mevcut olan labil duygulanımında ve psikomotor aktivitede artışla birlikte çağrışımlarda dağılma gözlenmiştir. Bunun üzerine hastaya Risperidon ve Karbamazepin tedavisi başlanmıştır. Psikotrop tedavinin ikinci gününde semptomlarda belirgin bir düzelme olmuştur. Steroid tedavisi ile gelişen duygudurum bozukluğu çok uzun yıllardır bilinen bir durum olmakla birlikte, hastamızda steroid tedavisi öncesinde de bazı semptomlar saptanmıştır. Hastanın bu durumu, steroid tedavisine bağlı bir duygudurum dönemi mi yoksa Behçet Hastalığı'na eşlik eden duygudurum bozukluğu mu olduğu açısından incelenmiştir. Bu yazıda literatürdeki benzer vakalar üzerinden bu birlikteliğin olası nedenleri tartışılmaktadır.

A 33 [year]s old woman who was suffering from Neuro-
Behcet's Disease had symptoms like loss of balance, vertigo
and affective lability. At the fourth day of steroid
treatment in addition to her labile affect and increased
psychomotor activity, increased speech and loosening of
associations were observed. Risperidone and
Carbamazepine were started and at the second day of
treatment the symptoms began to decrease. Affective
disorder caused by steroid treatment is well known. But
this patient also had symptoms before steroid treatment.
Was this situation related to steroid treatment or
was it an affective disorder comorbidity due to Behcet's
Disease? Central Nervous System involvement is 5-20%
in patients who are diagnosed with Behcet's Disease and
it is named as Neurobehcet Syndrome. The affected
areas in Neuro-Behcet Syndrome include brainstem,
spinal cord, and cerebral regions. Sometimes it is hard to
determine the affected area because symptoms are nonspesific.
Meningo-encephalic syndrome, focal neurological
deficits and dementia are the most seen clinical
appearences. Especially mental disorders such as cognitive
impairment are explicit in this disease.
Neuropsychiatric manifestations are relatively serious
complications in Neuro-Behcet Syndrome and 8-50% of
patients exhibit psychiatric symptoms. The initial signs
and symptoms of the syndrome are usually vague. This
makes Neuro-Behcet Syndrome hard to diagnose until
the patients experience severe neurological damages. In
this case report, relationship and potential causes of this
situation and steroid related affective disorders are compared
to similar situations in the literature.