Balo's Concentric Sclerosis:10 Years Follow-up
Balos’s concentric sclerosis is a rare subtype of demyelinating disease and is usually grouped as one of the atypical forms of multiple sclerosis. Historically, Balo’s concentric sclerosis was considered as aggressive, progressive disease leading to rapid deterioration and significant disability.
Very often diagnosis was made post mortem based on brain biopsy. Since emergence of MRI Balo’s disease can be diagnosed at onset of symptoms allowing for better treatment, hence substantially increasing rate and prognosis of recovery. Further, randomized controlled studies for treatment of Balo’s concentric sclerosis are scars and consensus for treatment is primarily based on case reports and clinical experience.
To describe, share and discuss clinical aspects of a case of patient with Balo’s concentric sclerosis, who has been treated and followed by us for 10 years.
Patient chart and literature review will be utilized to present a case of 46 years old female diagnosed 10 years ago with Balo’s Concentric Sclerosis.
A 46 years old female has been diagnosed with Balo’s concentric sclerosis in March 2006 and continues to show ongoing radiological and clinical stability at 10 years mark. Over the course of disease patient has had regular MRI’s, experienced three relapses, and is treated with Interferon beta 1a (Rebif) since November 2007 until present, her current expanded disability systems score (EDSS) is 2.0.
Balo’s concentric sclerosis is a rare demyelinating condition. Use of MRi allowed better understanding of radiological features of disease and made it possible to link lesion activity to clinical presentation. Nevertheless, natural history, treatment and prognosis of recovery need further studies. Due to rarity of disease large controlled studies are not possible. Ongoing sharing of experience through case presentations and continued collaboration among neurologist are essential for further understanding of Balo’s concentric sclerosis.
Presented case demonstrates patient with good recovery following initial attack, stable course and good response to therapy. Hopefully, this case will not only contribute to further understanding of disease but will also provide reassurance to patients diagnosed with Balo’s concentric sclerosis.