Is headache in Behçet's disease related to silent neurologic involvement?

OBJECTIVES Headache is an interesting issue in Behçet's disease (BD). This study aimed to investigate if headache or a special type of headache was correlated with silent neurologic involvement in BD patients without any neurologic sign. METHODS The study was performed on 120 BD patients (30 without headache, 30 with non-structural headache of BD and 30 with migraine headache, 30 with tension type headache) and 30 healthy control subjects. Some neurophysiologic tests of brain stem; temporalis muscle exteroceptive suppression periods (ESP) and brain stem auditory evoked potentials (BAEP) were performed in the patients, when they were not in an attack period of the disease, and control subjects to investigate the presence of silent neurologic involvement and the relation between headache and silent neurologic involvement. RESULTS Some electrophysiological abnormalities, as right BAEP 1-5 interpeak latency prolongation (p=0.01) and left ESP2 duration shortening (p<0.005), were seen in BD patients compared to healthy control subjects. Furthermore, the patients with non-structural headache of BD were found to have shorter ESP1 and 2 durations (p<0.001) and longer ESP1 latencies (p<0.05), with respect to the other patient subgroups with different types of headache and healthy control group, showing brain stem pathology. Additionally, they had longer right BAEP 3-5 interpeak latency as compared to the patient subgroup without headache (p=0.001). CONCLUSIONS There is a silent neurologic involvement in BD and this involvement may be in relation with a particular type of vascular headache, named as non-structural headache of BD. So, in clinical evaluation of BD patients, this type of headache may be considered as a warning message for neurological involvement.