Concentric sclerosis Baló
| Classification according to ICD-10 | |
|---|---|
| G37.5 | Concentric sclerosis [Baló's disease] |
| ICD-10 online (WHO version 2019) | |
The concentric sclerosis Baló is a rare acute inflammatory demyelinating disease of the central nervous system (CNS). It is synonymous with Baló's disease ( Latin: Baló's disease ), Baló's concentric sclerosis or as encephalitis periaxialis concentrica . The name of the disease goes back to the first description of the Hungarian pathologist József Baló in 1928.
The white matter lesions are characteristic of the disease . These are characterized by ring-shaped, alternately stronger and less marked white matter. This structure of the lesion produces the image of target-like lesions in the imaging by means of magnetic resonance tomography. In contrast to classic multiple sclerosis (MS), most patients with concentric sclerosis do not have any liquor-specific oligoclonal bands (approx. 34%; compared to> = 98% in MS).
The disease is characterized by an acute and often monophasic course. The symptoms that occur depend on the region of the brain affected. Young adults are particularly affected. Before the use of today's MRT technology, the diagnosis could only be made postmortem by means of histological examinations; in the cases described at the time, death usually occurred within a few weeks or months. Thanks to earlier diagnosis based on the characteristic Baló lesions in the MRI image, cases with a mild course have also been described more frequently in the last decade, and earlier treatment with often good outcome has become possible.
As with multiple sclerosis, therapy with high-dose therapeutic glucocorticoids is recommended. However, its effectiveness in concentric sclerosis has not been well documented. There are individual case reports for the effectiveness of plasmapheresis and immunosuppressants such as mitoxantrone . In approx. 50% of the cases, typical lesions of multiple sclerosis can also be seen in the MRI image. In some of these patients, the further course of the disease resembles normal multiple sclerosis, and some doctors use MS medication to prevent relapse.
Web links
Individual evidence
- ↑ Joseph Baló: encephalitis periaxialis concentrica. In: Arch Neurol Psychiatry . 19 (2), 1928, pp. 242-264, doi: 10.1001 / archneurpsyc. 1928.02210080044002
- ^ A b E. Capello, GL Mancardi: Marburg type and Balò's concentric sclerosis: rare and acute variants of multiple sclerosis. In: Neurol Sci. 25 Suppl 4, Nov 2004, pp. S361-S363. PMID 15727234
- ↑ Peter P. Urban: Diseases of the brain stem. Clinic - diagnostics - therapy. Schattauer-Verlag, Stuttgart et al. 2009, ISBN 978-3-7945-2478-5 , p. 238.
- ↑ S. Jarius, C. Würthwein, JR Behrens, J. Wanner, J. Haas, F. Paul, B. Wildemann: Baló's concentric sclerosis is immunologically distinct from multiple sclerosis: results from retrospective analysis of almost 150 lumbar punctures. In: J Neuroinflammation. 15 (1), 2018, p. 22. doi: 10.1186 / s12974-017-1043-y PMID 29347989
