From Baló's concentric sclerosis to multiple sclerosis: a series of 6 patients

Abstract

Introduction: Baló's concentric sclerosis (BCS) is a rare CNS disorder characterized by alternating bands of demyelination on MRI. One of the main issues is its relationship with multiple sclerosis (MS).

Objectives: To describe 6 BCS patients. To review the risk of developing MS in BCS patients.

Methods: We retrospectively recorded clinical and radiological findings of 6 BCS patients and performed a review of the literature.

Results: Six patients (5 women) with a mean age of 25 years old were included. Main symptoms were hemiparesis/hemihypoesthesia. On MRI, two patients had a single BCS lesion and four had additional MS-like lesions. Alternating bands were usually more visible on DWI. A patient had reduced central perfusion and SWI hypointensity suggestive of a central vein. Oligoclonal bands were identified in 5/6 patients. After 7 years of follow-up, all patients achieved MS criteria with mild disability (mean EDSS 1.75; 0-4). Our literature review included 65 BCS patients from 30 studies: although CSF oligoclonal bands and the presence of additional MS lesions were associated with subsequent relapses, this was not significant.

Discussion/conclusion: Our series allows a detailed MRI description in BCS and gives a new insight into BCS evolution and its strong relationship with MS.

Keywords: Baló’s concentric sclerosis; MRI; Multiple sclerosis.