MR Imaging Findings of Balo's Concentric Sclerosis, a Rare Variant of Multiple Sclerosis: a Case Report

Baló’s concentric sclerosis (BCS) is a rare demyelinating disease considered to be a variant of multiple sclerosis. The initial terminology for this entity was leuko-encephalitis periaxialis concentrica, which is based on its early definition of "a disease in the course of which the white matter of the brain is destroyed in concentric layers in a manner that leaves the axis cylinders intact". The most common clinical features are headache, aphasia, cognitive or behavioural dysfunction and/or seizures. CSF studies often reveal mononuclear inflammatory reaction and occasionally monoclonal bands. 2 The typical MR imaging changes associated with BCS consist of concentric rings or a whorled appearance on T2-weighted and contrast-enhanced T1-weighted images. Differentiating BCS from multiple sclerosis or neoplasm can be difficult clinically, but MR imaging findings noted in this case may be pathognomonic. In this case report we present a case of balo's concentric sclerosis diagnosed on MRI.