BEE syndromes

The triad of central nervous system symptoms, visual disturbance and hearing impairment is an oft-encountered clinical scenario. A number of immune-mediated diseases should be considered among the differential diagnoses including: Susac syndrome, Cogan syndrome or Vogt-Koyanagi-Harada disease; demyelinating conditions such as multiple sclerosis or neuromyelitis optica spectrum disorder; systemic diseases such as systemic lupus erythematosus, Sjögren syndrome or Behcet disease and granulomatous diseases such as sarcoidosis. In this article, Triplett et al., coined the term 'BEE syndromes' to draw attention to the various immune-mediated diseases that affect the brain, eye and ear.

We present common disease manifestations and identify key clinical and investigation features 1).

1)
Triplett JD, Buzzard KA, Lubomski M, Riminton DS, Barnett MH, Welgampola MS, Halmagyi GM, Nguyen M, Landau K, Lee AG, Plant GT, Fraser CL, Reddel SW, Hardy TA. Immune-mediated conditions affecting the brain, eye and ear (BEE syndromes). J Neurol Neurosurg Psychiatry. 2019 Mar 9. pii: jnnp-2018-319002. doi: 10.1136/jnnp-2018-319002. [Epub ahead of print] Review. PubMed PMID: 30852493.