Balo’s concentric sclerosis: an update and comprehensive literature review

Harandi, Ali Amini; Esfandani, Akram; Pakdaman, Hossein; Abbasi, Mehdi; Sahraian, Mohammad Ali

doi:10.1515/revneuro-2017-0096

Cited by 20 publications

(25 citation statements)

References 54 publications

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“…In some patients, BCS lesions might be seen during the course of relapsing–remitting MS. In contrast, half of the cases of Baló or Baló‐like lesions showed typical MS lesions as well 18 . However, it has been well established that BCS and MS‐like lesions might be present at the same time, suggesting a pathological overlap among the two conditions 36 .…”

Section: Discussionmentioning

confidence: 96%

“…Although BCS is often referred to as a variant of MS, 18 it is still unclear whether BCS is an acute variant of MS or a distinct entity that happens to coexist with MS 18 . In some patients, BCS lesions might be seen during the course of relapsing–remitting MS.…”

Section: Discussionmentioning

confidence: 99%

“…In other cases, patients showed a complete clinical and radiological recovery, especially when early diagnosis and prompt treatment were carried out 16,17 . Baló’s lesions might be detected during the clinical course of a relapsing–remitting form of MS 18 . Therefore, approximately half of the described cases of BCS showed typical MS lesions at MRI 16 .…”

Section: General Features Of Bscmentioning

confidence: 99%

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Magnetic resonance imaging of Baló’s concentric sclerosis: Literature review and presentation of two focused cases

Ballini¹,

F²,

Garofalo³

et al. 2020

Clinical & Exp Neuroim

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The aim of this study was to describe two cases of Baló’s concentric sclerosis, and to review the state‐of‐the‐art literature. This dissertation is the result of a critical analysis matching the literature and our professional experience. Data were synthesized into a narrative review. BCS is often referred to as a variant of multiple sclerosis (MS). It is still unclear whether BCS is an acute variant of MS or a distinct entity that happens to coexist with MS. BCS and MS‐like lesions might be present at the same time. BCS lesions are characterized by a large concentric “onion‐like” shape on MRI T2‐weighted images composed of alternating hypointense and hyperintense layers. On contrast‐enhanced T1‐weighted images, BCS active lesions usually show an enhancing and non‐enhancing pattern. The advancing edge of demyelination could be represented by peripheral restricted diffusion and contrast enhancement. Baló’s lesions is mainly found in the supratentorial white matter; however; the cerebellum, the brainstem and the spinal cord might be affected as well. The present two cases both showed onion‐like lesions; case 1 showed typical BCS features, whereas case 2 was atypical and could be classified as probably BCS or as a BCS‐like lesion in the course of MS. It is important for radiologists to be able to recognize this type of lesion and to cooperate with clinicians to help them carry out earlier diagnosis and treatment, determining a better clinical outcome for patients affected by BCS, even without histological confirmation, which is still considered the gold standard.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Section: General Features Of Bscmentioning

confidence: 99%

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Magnetic resonance imaging of Baló’s concentric sclerosis: Literature review and presentation of two focused cases

Ballini¹,

F²,

Garofalo³

et al. 2020

Clinical & Exp Neuroim

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“…BCS usually courses with solitary lesions, which may persist for years. These lesions may regress and resemble typical demyelinating plaques [ 1 , [3] , [4] , [5] , [6] ].…”

Section: Introductionmentioning

confidence: 99%

“…BCS relation with MS is still unclear, there is controversy on whether BCS is a variant of MS or separate entity [ [3] , [4] , [5] , [6] ]. Prior authors have hypothesized increased risk of progression to MS when multiple bands and/or oligoclonal bands are found.…”

Section: Introductionmentioning

confidence: 99%

Balo's Concentric Sclerosis with monophasic course: A report of 2 cases

Martínez

Rodriguez-Gonzalez

Escamilla-Garza

et al. 2021

Annals of Medicine &Amp; Surgery

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Introduction Balo's Concentric Sclerosis (BCS) is a rare demyelinating disease sometimes considered a variant of multiple sclerosis. It is characterized by an acute or subacute neurological symptoms with characteristic MRI “onion-like” white matter lesions. BCS has a wide range of presentations but is mostly self-limiting. Steroids are indicated in patients with aggressive disease. Case presentation We report 2 cases of BCS with monophasic course of stroke-like symptoms and single periventricular concentric lamella with onion-like appearance on MRI without inflammatory reaction in the CSF. They were treated with corticosteroids achieving clinical improvement and without neurological deficit or relapse over the following years. Clinical discussion A number of cases of BCS are described in the literature that show marked recovery with early diagnosis and treatment with steroids. Conclusion BCS appears to have a good prognosis when treated early in its diagnosis with steroids.

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Natural History of Multiple Sclerosis

Baldassari

Soldán

2021

Neuroimmunology

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Balo’s concentric sclerosis: an update and comprehensive literature review

Cited by 20 publications

References 54 publications

Magnetic resonance imaging of Baló’s concentric sclerosis: Literature review and presentation of two focused cases

Magnetic resonance imaging of Baló’s concentric sclerosis: Literature review and presentation of two focused cases

Balo's Concentric Sclerosis with monophasic course: A report of 2 cases

Natural History of Multiple Sclerosis

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