ATYPICAL MULTIPLE SCLEROSIS: SPECIAL ASPECTS OF DIFFERENTIAL DIAGNOSIS. A CLINICAL CASE OF BALO CONCENTRIC SCLEROSIS

The article presents a clinical case of a patient with Balo concentric sclerosis (BCS). BCS is characterized with brain white matter lesions with concentric layer structure where inflammation process goes from the center and interchanges with non-affected white matter. Literature analysis was performed and a short review of the disorder etiology and treatment is presented. MRI data, catamnesis (disorder outcome and results of repeated brain magnetic resonance imaging) allowed to prove a benign BCS. Differential diagnosis between CBS, infectious brain disorders and other atypical multiple sclerosis forms was a diagnostics challenge because of the absence of established diagnostic criteria for the disorder. Very few randomized clinical studies of CBS treatment exist at present because of the disorder heterogenic course and rareness. According to the consensus of scientists and clinical practitioners based on the presented clinical cases, corticosteroids are considered a recommended first line therapy. In cases of insufficient corticosteroids effectiveness the issue remains open. Alternative treatment methods such as plasma exchange, cyclophosphamide, and intravenous immunoglobulin can be used in some patients. Although there are still not enough data available to conclude on the advantages of one of the treatment methods.

Balo concentric sclerosis, atypical multiple sclerosis