SynonymsBalo's concentric sclerosis, Encephalitis Periaxialis Concentrica, Leukoencephalitis Periaxialis Concentric,
It is characterized by a tumor-like lesion larger than two centimeters and signs and symptoms similar to those of a brain tumor. It is a rare form of multiple sclerosis (MS). It is a very rare, rapidly progressive form of multiple sclerosis (inflammatory disease of the brain and spinal cord). It 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.
Symptoms of tumefactive MS often differ from other MS cases and may include, headaches, changes in thinking, confusion, speech problems, seizures, and weakness.
The symptoms of Balo disease vary depending on the areas of the brain that are affected, and can include:
- Muscle spasms
- Cognitive loss
- High fever
The cause of tumefactive MS is not known. It often develops into the relapsing-remitting form of MS. In other cases there is only one occurrence of the condition. In still others the disease process remains less clear.
The cause of Balo disease is not known, however, some studies indicate that autoimmune factors may play a role in its development. Autoimmune disorders are caused when the body’s natural defenses against “foreign” or invading organisms begin to attack healthy tissue for unknown reasons resulting in inflammation (swelling).
The process of diagnosis includes:
- A medical history
- A neurologic exam — a neurologist examines the person’s mobility, muscle strength, coordination, sensation, memory and thinking functions, speech and vision
- Magnetic resonance imaging (MRI) of the brain, optic nerves and spinal cord to identify damage to these areas and to detect the distinctive pattern often seen in Balo disease.
- Lumbar puncture (spinal tap) to examine the cerebrospinal fluid (CSF) may be performed
- Blood tests to detect possible infections
- Evoked potential (EP) testing helps find lesions or damaged areas in the nerves, spinal cord, optic nerve or brainstem
While Balo disease often results in severe disability or death within months, an increasing number of patients have been reported to survive or to have spontaneous remission with no further symptoms. It is also possible to have Balo disease and have no symptoms.
While there is no cure for tumefactive MS, treatments such as corticosteroids are available to decrease disease activity.
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 treatment with certain medications and referral to rehabilitation specialists.