Baló Concentric Sclerosis: Clinical, Radiologic, and Pathologic Observations

Baló concentric sclerosis (BCS) is a rare demyelinating disease with a variable prognosis. Researchers retrospectively evaluated radiologic, clinical, and pathology findings in patients referred to their center over several decades.

Of 40 patients, 29 had T2-weighted, alternating, concentric rings. Seven had Baló-like rings on non-T2–weighted sequences, or a mosaic pattern. Two had atypical lesions, and MRI was not available for two. Lesions typical for multiple sclerosis (MS) were observed in 13 of 38 patients, of whom 10 fulfilled MS diagnostic criteria. An established diagnosis of MS was present in 5 at the time of the BCS event. Fever, malaise, headache, and altered mental status were sometimes observed. Clinical course was monophasic in…