Balo Disease

4 mins read

Introduction
Balo Disease is a rare and progressive variant of multiple sclerosis. It generally occurs during adulthood. However, childhood cases have also been reported. While multiple sclerosis  is typically a disease that has a more or less sporadic mechanism, Balo Disease differs in being rapidly progressive. Balo Disease is manifested as bands of intact myelin (the sheath of fatty substances adjoining nerve fibers), alternating with rings of myelin loss (demyelination), in various parts of the brain and brain stem. The symptoms of Balo Disease vary, depending on the affected areas of the brain. Symptoms have been known to advance rapidly in a span of few weeks or gradually over two to three years.

Synonyms

  • Concentric Sclerosis
  • Encephalitis Periaxialis Concentrica
  • Leukoencephalitis Periaxialis Concentric

Causes
Balo disease may not be hereditary in nature, but genetics do play an important role. The most popular belief is that a viral infection or retroviral reactivation creates a susceptible immune system, which creates an abnormal reaction later in life.

It is commonly observed in people who live farther from the equator. Lack of sunlight exposure leads to decreased Vitamin D production, which may cause it. Even viruses have been reported to play a role in getting affected by MS.

Symptoms
Symptoms may include headache, seizures, gradual paralysis, involuntary muscle spasms, and cognitive loss.

It’s important to recognize the early symptoms of MS, and to understand the later symptoms for management. Multiple Sclerosis Tremors is associated with fatigue in patients. MS Hug or MS girdle are used as terms to describe a band of pain in the torso associated with multiple sclerosis.

Diagnosis & Tests
An early diagnosis can slow the disease. Hence, timely treatment is of utmost importance. There is no single test that is proof-positive for diagnosing multiple sclerosis.

Magnetic Resonance Imaging (MRI) is a giant step in confirming the diagnosis. The Spinal Tap & Multiple Sclerosis provides an effective clue for diagnosis.

Evoked Potential Test is a painless test that measures electrical activity in the brain to help diagnose MS.

Treatment
Several drugs that can help slow Multiple Sclerosis. Deep Brain Stimulation, a surgical procedure is effective in treating Multiple Sclerosis Tremors. Plasma Exchange (also called Plasmapheresis) is one possible treatment for MS. Controlling Muscle Spasms and managing bladder control are few challenges for MS patient.

Ampyra (dalfampridine) is a novel treatment option for MS. Interferon beta drugs such as Cytoxan slows MS progression. This acts like proteins produced by the body for the immune system. Imuran (azathioprine) is another drug used to slow the progression of MS by suppressing immunity. Baclofen is a common treatment for spasticity associated with neurological diseases. Botox (botulinum toxin) relaxes muscles and reduces spasticity.

Potent IV steroids are sometimes used to reduce and control the symptoms of an acute attack of multiple sclerosis. Tysabri (natalizumab) is a treatment option to delay the progression of MS and reduce flare-ups.

Alternative Therapy
Acupuncture and relaxation methods such as meditation, Tai Chi and Yoga can largely help to relieve the pain. Cranberries and Vitamin D supplements are helpful to alleviate symptoms associated with MS.

Homeopathic Treatment
Causticum, Gelsemium, Natrum-mur, Phosphorus, Alumina, Thuja, Belladonna, Lycopodium, Sulfur and several other drugs have been used in treatment of MS. Consult a specialist to get the exact prescription for treating Balo disease.


References
1. Ng SH, Ko SF, Cheung YC, Wong HF, Wan YL. MRI features of Balo’s concentric sclerosis.Br J Radiol 1999;72:400-403

2. Tersegno MM, Reich DR. Balo’s concentric sclerosis: a rare form of multiple sclerosis manifested as a dominant cerebral mass without other white matter lesions on MR.AJR Am J Roentgenol 1993;160:901

3. Izumi T, Kusaka H, Matsuura S, Sumimoto T. Acute leukoencephalopathy in Filipino women: report of two cases.Rinsho Shinkeigaku 1995;35:55-59

4. Chen CJ, Chu NS, Lu CS, Sung CY. Serial magnetic resonance imaging in patients with Balo’s concentric sclerosis: natural history of lesion development.Ann Neurol 1999;46:651-656

5. Korte JH, Bom EP, Vos LD, Breuer TJ, Wondergem JH. Balo concentric sclerosis: MR diagnosis.AJNR Am J Neuroradiol 1994;15:1284-1285

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