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[Balo concentric sclerosis. Report of one case]
E Rivera1, L Badilla, J Eurolo
1Servicio de Neurología Hospital Carlos Van Buren, Valparaíso, Instituto de Neurocirugía Asenjo, Santiago, Chile.
Revista Medica De Chile
|August 1, 1997
Summary
A 50-year-old woman presented with progressive dysphagia and disarthria, developing right hemiparesis. The diagnosis was Balo concentric sclerosis, a rare progressive demyelinating disease, resulting in severe disabilities.
Area of Science:
- Neurology
- Neuroimmunology
- Neuroscience
Background:
- Balo concentric sclerosis is a rare, often rapidly progressive, demyelinating disorder of the central nervous system.
- It is characterized by alternating shells of demyelination and relative preservation of myelin.
- Distinguishing Balo concentric sclerosis from other demyelinating diseases can be challenging clinically and radiologically.
Observation:
- A 50-year-old female patient presented with a three-week history of progressive dysphagia and disarthria.
- On admission, right hemiparesis was observed, alongside abnormal findings on brain CAT scan including bilateral subcortical hypodense zones with contrast enhancement.
- Neurological deficits, including pseudobulbar palsy and hemiparesis, worsened, necessitating nasoenteral feeding.
Findings:
- Cerebrospinal fluid (CSF) analysis revealed elevated protein levels (9 mg/dl) but no cells, suggesting an inflammatory or demyelinating process.
- Brain imaging demonstrated characteristic, albeit atypical, features suggestive of Balo concentric sclerosis.
- The patient's clinical course was marked by rapid deterioration leading to severe disabilities.
Implications:
- This case highlights the diagnostic challenges associated with Balo concentric sclerosis, particularly in its early or atypical presentations.
- Early recognition and accurate diagnosis are crucial for appropriate management, although treatment options for Balo concentric sclerosis remain limited.
- Further research into the pathogenesis and treatment of this rare demyelinating disease is warranted.