Introduction Neuro-Behçet’s is rare, more frequent in people from the Middle East. Vasculitis of brainstem and diencephalon and venous sinus thrombosis are typical manifestations. Case report A previously well 51-year-old white British lady was admitted for a 2 day history of blurred vision, with impaired up-gaze and convergence retraction nystagmus. The symptoms resolved rapidly. MRI demonstrated hyperintensities in the diencephalon, CSF showed 10 mononuclear cells, normal otherwise. She was re-admitted eighteen months later with sudden imbalance, headache, slurred speech and right facial weakness. She reported mouth ulcers appearing in crops continuously over the past 2 years, no genital ulcers. MRI showed T2 hyperintensities in the thalami extending into the mid-brain, pons and superior and middle cerebellar peduncles. CSF showed 54 mononucleate cells, proteins 0.67 g, and raised CSF IL-6. The symptoms resolved spontaneously. Multimodal MRI one week later showed near resolution of the lesions. After excluding neoplastic, vascular and infective causes, probable neuro- Behçet’s was diagnosed according to the International Consensus Recommendations criteria (2014). The patient remains on steroids and azathioprine, and is asymptomatic at one year. Conclusions Neuro-Behçet’s can present with relapsing brainstem symptoms. The diagnosis is challenging when not all the criteria for the systemic condition are met.

Aims Peadiatric neurology transition is recommended as a planned and well-structured move to the adult neurologist beginning in early adolescence. However, this process may be distilled into a single ‘transfer’ clinic. We investigated whether this was satisfactory for the young person involved and surveyed the UK experience of neurology transition. Methods A questionnaire was designed and completed by young people and neurologists at transfer clinics in Birmingham. Additionally, an online local transition/transfer policy survey was sent to UK adult and paediatric neurologists. Results The young person9s questionnaires (n=18) demonstrated wide variation in knowledge about their condition and transition aspects of the disease; all patients were satisfied with their care. Most respondents of the online survey (52%; 43/82) did not have a Transition guideline/policy; only 36% (27/82) held early adolescent transition clinics. The main barriers to a transition process were lack of clinic time/space and skilled support staff; 60% (48/82) thought provision for transition/transfer did not meet national standards. Conclusions Transition from paediatric to adult neurology services occurs mainly as single transfer clinics which is acceptable to young people. Professionals feel that they and patients would benefit from a transition process if resources/training were available, this is now underway in Birmingham.