A case of neuro-Behçet's disease started with diplopia

Neurological symptoms of neuro-Behçet' disease are varied. But among them diplopia is rare. We describe a rare case of neuro-Behçet's disease that neurological lesions in paramedian pontine reticular formation (PPRF) showed concomitant strabismus and diplopia. In 1975 a 25-year old male developed recurrent oral aphthae, painful genital ulcers, and acne-like skin lesions on his face. In 1982 he felt impairment of visual activity. Diagnosis of Behçet's disease was made and colchicine therapy was started. In 1988 he abruptly developed fever, headache and diplopia, and he was hospitalized. The left eye was deviated to the right and movements of both eyes to the left were limited. Other neurological symptoms were not observed. Neurological examinations revealed that diplopia wasn't due to cranial nerve palsy but CNS Behçet's lesions in PPRF. But lesions in PPRF were too small to detect by brain CT and MRI. After corticosteroids therapy diplopia was disappeared.