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Concentric MR patterns in multiple sclerosis. Report of two cases

M P Revel1, E Valiente, F Gray

  • 1Service de Neuroradiologie, Hôpital Henri-Mondor, Créteil.

Journal of Neuroradiology = Journal De Neuroradiologie
|December 1, 1993
PubMed
Summary

Two multiple sclerosis cases showed concentric demyelination patterns on MRI, resembling Balò's disease. Acute onset and regression with steroids suggest Balò's disease may be transient.

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Area of Science:

  • Neurology
  • Radiology
  • Pathology

Background:

  • Multiple sclerosis (MS) is a chronic inflammatory demyelinating disease of the central nervous system.
  • Balò's concentric sclerosis is a rare, often fatal, variant of MS characterized by concentric rings of demyelination.
  • Magnetic Resonance Imaging (MRI) is crucial for diagnosing and monitoring MS.

Observation:

  • Two patients presented with multiple sclerosis exhibiting unusual concentric patterns of demyelinated lesions on T2-weighted MRI.
  • These concentric patterns appeared as alternating high and low signal intensity areas, consistent with concentric demyelination.
  • The observed MRI findings were compared with pathological data of Balò's disease.

Findings:

  • The MRI findings in these cases strongly suggest a concentric pattern of demyelination.

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  • Both patients experienced acute onset of neurological symptoms.
  • Significant regression of symptoms was observed following corticosteroid therapy.
  • Implications:

    • These findings challenge the traditional view of Balò's disease as invariably fatal.
    • The acute onset and favorable response to treatment suggest that Balò's concentric sclerosis may represent a transient form of MS.
    • Further research is warranted to understand the pathophysiology and long-term prognosis of this MS variant.