Expert Opinion Behçet Syndrome and Headache

CLINICAL HISTORY A 37-year-old woman presented for evaluation of frequent headache. One year previously, she had a sudden severe pain (“like an axe”) in the back of the head, with maximum intensity at the onset and representing the worst headache of her life. Computed tomography of the brain and cerebrospinal fluid examination were normal. She subsequently experienced frequent headaches. She described a constant dull aching in the back and on both sides of her head, and 1 to 2 days per week she experienced occipital and bilateral retroorbital throbbing with associated light and noise sensitivity, but no nausea or aura. Once every 2 weeks, she had a back-of-the-head and generalized throbbing headache with associated nausea, light sensitivity, and noise sensitivity, lasting up to 4 days. She had occasional mild headaches in the past more than a year ago. Her neurologic review of systems was notable for mild memory problems. She reported having had recurrent oral and vaginal ulcers, aching of her knees and ankles, and a skin