Balo's Concentric Sclerosis with monophasic course: A report of 2 cases

Ann Med Surg (Lond). 2021 Jul 28:68:102602. doi: 10.1016/j.amsu.2021.102602. eCollection 2021 Aug.


Introduction: Balo's Concentric Sclerosis (BCS) is a rare demyelinating disease sometimes considered a variant of multiple sclerosis. It is characterized by an acute or subacute neurological symptoms with characteristic MRI "onion-like" white matter lesions. BCS has a wide range of presentations but is mostly self-limiting. Steroids are indicated in patients with aggressive disease.

Case presentation: We report 2 cases of BCS with monophasic course of stroke-like symptoms and single periventricular concentric lamella with onion-like appearance on MRI without inflammatory reaction in the CSF. They were treated with corticosteroids achieving clinical improvement and without neurological deficit or relapse over the following years.

Clinical discussion: A number of cases of BCS are described in the literature that show marked recovery with early diagnosis and treatment with steroids.

Conclusion: BCS appears to have a good prognosis when treated early in its diagnosis with steroids.

Keywords: Balo's concentric sclerosis; Balo's disease; Demyelinating; Multiple sclerosis; Stroke mimic.

Publication types

  • Case Reports