Demyelinating lesions with features of Balo's concentric sclerosis in a patient with active hepatitis C and human herpesvirus 6 infection

Ferreira, Deimy Lima; Castro, Sonia de; Nadais, Goreti; Costa, J. M. Dias; Fonseca, J. M.

doi:10.1111/j.1468-1331.2010.03201.x

Cited by 12 publications

(5 citation statements)

References 7 publications

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“…Balo's concentric sclerosis-like lesions have been reported in patients with NMO, cerebral autosomal dominant arteriopathy with subcortical infarcts, and leukoencephalopathy (CADASIL), progressive multifocal leukoencephalopathy, and human herpes virus 6 infection. [30][31][32][33][34] Marburg's variant of MS, first described by Dr. Otto Marburg in 1906, is defined by acute-onset fulminant demyelination with a relentlessly progressive course that often leads to death within months. 35 Although TMS and BCS are defined by imaging and histopathologic appearance, MVMS is defined by its clinical course.…”

Section: Ms Variants: Tumefactive Ms Balo's Concentric Sclerosis Mamentioning

confidence: 99%

Fulminant Demyelinating Diseases of the Central Nervous System

Bevan¹,

Cree²

2015

Semin Neurol

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Fulminant demyelinating diseases of the central nervous system include acute disseminated encephalomyelitis, the related acute hemorrhagic leukoencephalitis, multiple sclerosis variants, neuromyelitis optica spectrum disorders, and idiopathic transverse myelitis. These syndromes are often managed with similar acute treatments including high-dose corticosteroids and plasmapheresis; however, long-term management varies. Although the prognosis of fulminant demyelinating disease was historically poor, outcomes today may be improved due to earlier diagnosis, rapid implementation of anti-inflammatory therapies such as high-dose corticosteroids and plasmapheresis, and improved supportive care.

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Section: Ms Variants: Tumefactive Ms Balo's Concentric Sclerosis Mamentioning

confidence: 99%

Fulminant Demyelinating Diseases of the Central Nervous System

Bevan¹,

Cree²

2015

Semin Neurol

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“…An association with progressive multifocal leukoencephalopathy has been rarely described; whereas a history of intravenous drug abuse and hepatitis C virus‐related liver disease, as well as cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy have been reported 13,14 . CSF findings, OCB and immunoglobulin G index did not always show intrathecal synthesis 6 .…”

Section: General Features Of Bscmentioning

confidence: 97%

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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“…Ferriera et al [85] reported a case of Balo's concentric sclerosis in the setting of co-infection with HCV and HHV-6. HCV RNA was detected in the serum and HHV-6 DNA was detected in the CSF by PCR.…”

Section: Central Nervous System Disorders With Hepatitis C Infectionmentioning

confidence: 98%

Neurological Complications of Hepatitis C Infection

McCarthy

Ortega

2012

Curr Neurol Neurosci Rep

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Though well-known as a cause of liver disease, Hepatitis C virus infection is emerging as a cause of a variety of peripheral and central nervous system disorders. The virus causes chronic persistent infection with complex immune responses in the majority of individuals. Viral infection may have the potential to generate neurological illness through direct infection of neural cells or through immune-mediated mechanisms, including enhancement of autoimmune responses. Moreover, the mainstay of antiviral treatment of hepatitis C infection, interferon-alpha, is itself associated with neurological morbidity. Thus neurologists are increasingly faced with diagnosing or even predicting a wide spectrum of neurological complications of hepatitis C infection and/or its treatment.

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Demyelinating lesions with features of Balo's concentric sclerosis in a patient with active hepatitis C and human herpesvirus 6 infection

Cited by 12 publications

References 7 publications

Fulminant Demyelinating Diseases of the Central Nervous System

Fulminant Demyelinating Diseases of the Central Nervous System

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

Neurological Complications of Hepatitis C Infection

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