An Abnormal MRI Signal in Both Lateral Geniculate Bodies Is a Diagnostic Indicator for Patients with Behcet's Disease

A few case reports involving Behcet's disease have described visual field defects ascribed to the lateral geniculate body; however, no cases of lesions in both lateral geniculate bodies have been reported. A 50-year-old male who had fever and genital ulceration 3 months earlier noticed visual field defects. A T2-weighted MRI and FLAIR image showed high-intensity lesions in both lateral geniculate bodies. The posterior end of the optic tracts and lateral geniculate bodies were bilaterally enhanced with gadolinium. Because of the presence of three (aphthous stomatitis, genital ulceration and uveal inflammation) of the four major symptoms, the patient was diagnosed with an abortive type of Behcet's disease and started predonisolone at a dose of 0.5 mg/kg, after which he showed a rapid improvement of all symptoms. The lesions in the lateral geniculate bodies had disappeared on the MRI images taken 2 weeks after treatment onset. In addition to Behcet's disease, several case reports have observed lesions in both lateral geniculate bodies. Their visual field defects disappeared within half a year, in parallel with the healing process of the primary diseases. The pathogenesis of the lesions in both lateral geniculate bodies in these cases is believed to be related to the underlying disorders, especially vascular involvement from inflammation. The appearance of lesions in both lateral geniculate bodies on MRI scans may indicate the presence of systemic inflammatory diseases such as Behcet's disease, but further examinations are required. (C) 2014 S. Karger AG, Basel