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. 1997 Jun;62(6):655–658. doi: 10.1136/jnnp.62.6.655

Balo's concentric sclerosis: a clinical case study of brain MRI, biopsy, and proton magnetic resonance spectroscopic findings.

M O Kim 1, S A Lee 1, C G Choi 1, J R Huh 1, M C Lee 1
PMCID: PMC1074158  PMID: 9219760

Abstract

The antemortem diagnosis of Balo's concentric sclerosis was made in a 52 year old woman with subacute right hemiparesis on the basis of brain MRI and stereotactic brain biopsy, which showed multiple ring-like lesions of lamellated demyelination alternating with spared white matter. Proton magnetic resonance spectroscopy (1H-MRS) was carried out one and nine months after the onset of illness. The first 1H-MRS showed a decreased N-acetyl aspartate peak, an increased choline peak, presence of large lipid peaks, and high resonance at 1.4 ppm. The second 1H-MRS disclosed changes such as a decrease of lipid signal, a decrease of resonance at 1.4 ppm, and an increase in the myoinositol peak. These findings are similar to those reported for multiple sclerosis. It seems that this is the first report of 1H-MRS findings in Balo's concentric sclerosis.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Callies R., Sri-Pathmanathan R. M., Ferguson D. Y., Brindle K. M. The appearance of neutral lipid signals in the 1H NMR spectra of a myeloma cell line correlates with the induced formation of cytoplasmic lipid droplets. Magn Reson Med. 1993 Apr;29(4):546–550. doi: 10.1002/mrm.1910290418. [DOI] [PubMed] [Google Scholar]
  2. Davie C. A., Hawkins C. P., Barker G. J., Brennan A., Tofts P. S., Miller D. H., McDonald W. I. Detection of myelin breakdown products by proton magnetic resonance spectroscopy. Lancet. 1993 Mar 6;341(8845):630–631. doi: 10.1016/0140-6736(93)90390-3. [DOI] [PubMed] [Google Scholar]
  3. Davie C. A., Hawkins C. P., Barker G. J., Brennan A., Tofts P. S., Miller D. H., McDonald W. I. Serial proton magnetic resonance spectroscopy in acute multiple sclerosis lesions. Brain. 1994 Feb;117(Pt 1):49–58. doi: 10.1093/brain/117.1.49. [DOI] [PubMed] [Google Scholar]
  4. Davies S. E., Newcombe J., Williams S. R., McDonald W. I., Clark J. B. High resolution proton NMR spectroscopy of multiple sclerosis lesions. J Neurochem. 1995 Feb;64(2):742–748. doi: 10.1046/j.1471-4159.1995.64020742.x. [DOI] [PubMed] [Google Scholar]
  5. Garbern J., Spence A. M., Alvord E. C., Jr Balo's concentric demyelination diagnosed premortem. Neurology. 1986 Dec;36(12):1610–1614. doi: 10.1212/wnl.36.12.1610. [DOI] [PubMed] [Google Scholar]
  6. Gharagozloo A. M., Poe L. B., Collins G. H. Antemortem diagnosis of Baló concentric sclerosis: correlative MR imaging and pathologic features. Radiology. 1994 Jun;191(3):817–819. doi: 10.1148/radiology.191.3.8184071. [DOI] [PubMed] [Google Scholar]
  7. Itoyama Y., Tateishi J., Kuroiwa Y. Atypical multiple sclerosis with concentric or lamellar demyelinated lesions: two Japanese patients studied post mortem. Ann Neurol. 1985 May;17(5):481–487. doi: 10.1002/ana.410170511. [DOI] [PubMed] [Google Scholar]
  8. Kauppinen R. A., Nissinen T., Kärkkäinen A. M., Pirttilä T. R., Palvimo J., Kokko H., Williams S. R. Detection of thymosin beta 4 in situ in a guinea pig cerebral cortex preparation using 1H NMR spectroscopy. J Biol Chem. 1992 May 15;267(14):9905–9910. [PubMed] [Google Scholar]
  9. Korte J. H., Bom E. P., Vos L. D., Breuer T. J., Wondergem J. H. Baló concentric sclerosis: MR diagnosis. AJNR Am J Neuroradiol. 1994 Aug;15(7):1284–1285. [PMC free article] [PubMed] [Google Scholar]
  10. Nandini M., Gourie-Devi M., Shankar S. K., Mustare V. B., Ravi V. Balo's concentric sclerosis diagnosed intravitam on brain biopsy. Clin Neurol Neurosurg. 1993 Dec;95(4):303–309. doi: 10.1016/0303-8467(93)90106-q. [DOI] [PubMed] [Google Scholar]
  11. Revel M. P., Valiente E., Gray F., Beges C., Degos J. D., Brugières P., Gaston A. Concentric MR patterns in multiple sclerosis. Report of two cases. J Neuroradiol. 1993 Dec;20(4):252–257. [PubMed] [Google Scholar]
  12. Richards T. L. Proton MR spectroscopy in multiple sclerosis: value in establishing diagnosis, monitoring progression, and evaluating therapy. AJR Am J Roentgenol. 1991 Nov;157(5):1073–1078. doi: 10.2214/ajr.157.5.1927795. [DOI] [PubMed] [Google Scholar]
  13. Roser W., Hagberg G., Mader I., Brunnschweiler H., Radue E. W., Seelig J., Kappos L. Proton MRS of gadolinium-enhancing MS plaques and metabolic changes in normal-appearing white matter. Magn Reson Med. 1995 Jun;33(6):811–817. doi: 10.1002/mrm.1910330611. [DOI] [PubMed] [Google Scholar]
  14. Spiegel M., Krüger H., Hofmann E., Kappos L. MRI study of Baló's concentric sclerosis before and after immunosuppressive therapy. J Neurol. 1989 Dec;236(8):487–488. doi: 10.1007/BF00328514. [DOI] [PubMed] [Google Scholar]
  15. Yao D. L., Webster H. D., Hudson L. D., Brenner M., Liu D. S., Escobar A. I., Komoly S. Concentric sclerosis (Baló): morphometric and in situ hybridization study of lesions in six patients. Ann Neurol. 1994 Jan;35(1):18–30. doi: 10.1002/ana.410350105. [DOI] [PubMed] [Google Scholar]

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