A 28-years-old male patient with recurrent oral and genital ulcer history and folliculitis presents 48 h progressive fever, headache, nausea, right sixth cranial nerve palsy, and right upper limb paresis. The CSF showed lymphocyte pleocytosis and high proteinorrachia, so antibiotic treatment was initiated. Cerebral MR found hyperintense enhancing lesions in the brainstem and left transverse sinus thrombosis. Patient improved with endovenous corticosteroids and was discharged asymptomatic.
Neurological involvement in Beh?et's disease is rare and moreover the coexistence of parenchymatous and non-parenchymatous alterations in the same patient. It normally has a good response to immunosuppressant treatment.