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

• Published in: Annals of medicine and surgery 2021-08, Vol.68, p.102602, Article 102602
• Main Authors: Martinez, Hector R., Rodriguez-Gonzalez, Irving Christian, Escamilla-Garza, Juan M., Figueroa-Sanchez, Jose A., Garcia-Aleman, Axel Cruz, Hinojosa-Gonzalez, David Eugenio
• Format: Article
• Language: English
• Subjects: Balo's concentric sclerosis; Balo's disease; Case Report; Demyelinating; Multiple sclerosis; Stroke mimic
• ISSN: 2049-0801; 2049-0801
• DOI: 10.1016/j.amsu.2021.102602

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. 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. A number of cases of BCS are described in the literature that show marked recovery with early diagnosis and treatment with steroids. BCS appears to have a good prognosis when treated early in its diagnosis with steroids. •Balos Concentric Sclerosis is a rare acute demyelinating disorder.•BCS is typically self-limited and most reported cases have full remission.•2 cases of BCS were successfully treated with steroids.•Further efforts must be made to determine its association with multiple sclerosis.