Balo Disease is a rare and progressive variant of multiple sclerosis. It usually first appears in adulthood, but childhood cases have also been reported. While multiple sclerosis typically is a disease that waxes and wanes, Balo Disease is different in that it tends to be rapidly progressive. Symptoms may include headache, seizures, gradual paralysis, involuntary muscle spasms, and cognitive loss. The alternative names for Balo Disease, concentric sclerosis or Balo concentric sclerosis, refer to the fact that Balo Disease is characterized by bands of intact myelin (the sheath of fatty substances surrounding nerve fibers), alternating with rings of loss of myelin (demyelination), in various parts of the brain and brain stem. The symptoms of Balo Disease vary, according to the areas of the brain that are affected. Symptoms may progress rapidly over several weeks or more slowly over two to three years.
Most cases are characterized by the gradual onset of symptoms that might be found in the more common type of MS, including muscle spasms and paralysis. Other neurological symptoms develop depending on the areas of the brain that are affected and may include intellectual impairment and/or physiological abnormalities. However, in its most serious form, Balo Disease may also suggest the presence of an infectious disease, starting with a high fever and painful headaches.
The cause of MS and its variants remains unknown. However, some studies indicate that autoimmune factors may play a role in the development of Balo Disease. Autoimmune disorders are caused when the body’s natural defenses against “foreign” or invading organisms (e.g., antibodies) begin to attack healthy tissue for unknown reasons.
Balo Disease is a rare disorder that affects males and females in equal numbers. More cases have been reported from China and the Philippines than elsewhere.
Treatment is symptomatic and supportive. Corticosteroids are usually useful in decreasing severity of acute presentations through their anti-inflammatory actions. Treatment to relieve symptoms, such as spasticity, weakness, pain, or ataxia, includes pharmacologic and rehabilitative modalities.
Therapies Investigational
Information current clinical trials is posted on the Internet at www.clinicaltrials.gov. All
studies receiving U.S. government funding, and some supported by private industry, are posted on this government web site.
For information about clinical trials being conducted at the NIH Clinical Center in Bethesda, MD, contact the NIH Patient Recruitment Office:
Tollfree: (800) 411-1222
TTY: (866) 411-1010
Email: [email protected]
For information about clinical trials sponsored by private sources, contact:
www.centerwatch.com
TEXTBOOKS
Giesser BS. Rare Variants of Multiple Sclerosis. In: NORD Guide to Rare Disorders. Lippincott Williams & Wilkins. Philadelphia, PA. 2003:560.
Adams RD, Victor M, Ropper AA. Eds. Principles of Neurology. 6th ed. McGraw-Hill Companies. New York, NY; 1997:915.
Menkes JH, Pine Jr JW, et al. Eds. Textbook of Child Neurology. 5th ed. Williams & Wilkins. Baltimore, MD; 1995:535.
REVIEW ARTICLES
Dupel-Pottier C. [Diagnostic criteria of borderline forms of multiple sclerosis] Rev Neurol (Paris). 2001;157(8-9 Pt 2):935-43. French
Fontaine B. [Borderline forms of multiple sclerosis] Rev Neurol (Paris). 2001;157(8-9 Pt 2):929-34. French
Moser HW. Neurometabolic disease. Curr Opin Neurol. 1998;11:91-95.
JOURNAL ARTICLES
Moore GR, Berry K, Oger JJ, et al. Balo’s concentric sclerosis: surviving normal myelin in a patient with relapsing-remitting clinical course. Mult Scler. 2001;7:375-82.
Kastrup O, Stude P, Limmroth V. Balo’s concentric sclerosis. Evolution of active demyelination demonstrated by serial contrast-enhanced MRI. J Neurol. 2002;249:811-14.
Karaaslan E, Altintas A, Senol U, et al. Balo’s concentric sclerosis: clinical and radiological features of five cases. AJNR Am J Neuroradiol. 2001;22:1362-67.
Chen CJ. Serial proton magnetic resonance spectroscopy in lesions of Balo’s concentric sclerosis. J Comput Assist Tomogr. 2001;25:713-18.
Caracciolo JT, Murtagh RD, Rojiani AM, et al. Pathognomic MR imaging in Balo concentric sclerosis. AJNR Am J Neuroradiol. 2001;22:292-93.
Iannucci G, Mascalchi M, Salvi F, et al. Vanishing Balo-like lesions in multiple sclerosis. J Neurol Neurosurg Psychiatry. 2000;69:399-400.
Singh S, Kuruvilla A, Alexander M, et al. Balo’s concentric sclerosis: value of magnetic resonance imaging in diagnosis. Australas Radiol. 1999;43:400-04.
Chen CJ, Chu NS, Lu CS, et al. Serial magnetic resonance imaging in patients with Balo’s concentric sclerosis: natural history of lesion development. Ann Neurol. 1999;46:651-56.
FROM THE INTERNET
Balo Disease. nd. 1p.
www.kovaidoctors.com/diseases/b/b4.php
What is Multiple Sclerosis? Last Modified; 12/20/2002:4pp.
www.mult-sclerosis.org/whatisms.html
How does Multiple Sclerosis do its damage? Last Modified; 11/27/2002:4pp.
www.mult-sclerosis.org/howms.html
The information in NORD’s Rare Disease Database is for educational purposes only and is not intended to replace the advice of a physician or other qualified medical professional.
The content of the website and databases of the National Organization for Rare Disorders (NORD) is copyrighted and may not be reproduced, copied, downloaded or disseminated, in any way, for any commercial or public purpose, without prior written authorization and approval from NORD. Individuals may print one hard copy of an individual disease for personal use, provided that content is unmodified and includes NORD’s copyright.
National Organization for Rare Disorders (NORD)
55 Kenosia Ave., Danbury CT 06810 • (203)744-0100