We present a patient with a history of myelitis, who had a steroid refractory attack of CNS inflammatory demyelinating disease that developed into cerebral concentric sclerosis of Balo after plasma exchange. The acute inflammatory disease involved the spinal cord, a phenomenon rarely demonstrated. This patient fulfilled the McDonald criteria for multiple sclerosis. Plasmapheresis did not have a beneficial effect, but the patient stabilised at high EDSS after treatment with mitoxantron.
Abbreviations:PE (Plasma exchange), MS (Multiple Sclerosis), BCS (Balo's concentric sclerosis), EDSS (Expanded disability status scale), C (cervical), Th (thoracic)
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- Serial magnetic resonance imaging in patients with Balo's concentric sclerosis: natural history of lesion development.Ann Neurol. Oct 1999; 46: 651-656
- Technology insight: can neuroimaging provide insights into the role of ischemia in Balo's concentric sclerosis?.Nat Clin Pract Neurol. Jun 2007; 3: 341-348
- Balo's concentric sclerosis: new observations on lesion development.Ann Neurol. Jun 1985; 17: 604-611
- A randomized trial of plasma exchange in acute central nervous system inflammatory demyelinating disease.Ann Neurol. Dec 1999; 46: 878-886
- Serial magnetic resonance imaging (MRI) study of a patient with Balo's concentric sclerosis treated with immunoadsorption plasmapheresis.Mult Scler. Jan 1997; 2: 291-294
- Serial gadolinium-enhanced MRI in acute attack of multiple sclerosis treated with plasma exchange.J Neurol. Feb 2003; 250: 243-244
- Balo's concentric sclerosis. Evolution of active demyelination demonstrated by serial contrast-enhanced MRI.J Neurol. Jul 2002; 249: 811-814
- Balo's concentric sclerosislike lesion in the brainstem of a multiple sclerosis patient.J Neurol. Feb 25 2008; 255: 760-761
- Balo's concentric sclerosis: surviving normal myelin in a patient with a relapsing–remitting clinical course.Mult Scler. Dec 2001; 7: 375-382
- Revised diagnostic criteria for neuromyelitis optica.Neurology. May 23 2006; 66: 1485-1489
- Concentric sclerosis (Balo): morphometric and in situ hybridization study of lesions in six patients.Ann Neurol. Jan 1994; 35: 18-30
- Tissue preconditioning may explain concentric lesions in Balo's type of multiple sclerosis.Brain. May 2005; 128: 979-987
Published online: February 02, 2009
Accepted: December 23, 2008
Received in revised form: December 18, 2008
Received: October 10, 2008
© 2009 Elsevier B.V. Published by Elsevier Inc. All rights reserved.