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Ayrignac X, Letourneau-Guillon L, Carra-Dallière C, Duquette P, Girard M, Poirier J, Lahav B, Larochelle C, Prat A. From Baló's concentric sclerosis to multiple sclerosis: a series of 6 patients. Mult Scler Relat Disord 2020; 42:102078. [PMID: 32408148 DOI: 10.1016/j.msard.2020.102078] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Revised: 03/20/2020] [Accepted: 03/28/2020] [Indexed: 12/22/2022]
Abstract
INTRODUCTION Baló's concentric sclerosis (BCS) is a rare CNS disorder characterized by alternating bands of demyelination on MRI. One of the main issues is its relationship with multiple sclerosis (MS). OBJECTIVES To describe 6 BCS patients. To review the risk of developing MS in BCS patients. METHODS We retrospectively recorded clinical and radiological findings of 6 BCS patients and performed a review of the literature. RESULTS Six patients (5 women) with a mean age of 25 years old were included. Main symptoms were hemiparesis/hemihypoesthesia. On MRI, two patients had a single BCS lesion and four had additional MS-like lesions. Alternating bands were usually more visible on DWI. A patient had reduced central perfusion and SWI hypointensity suggestive of a central vein. Oligoclonal bands were identified in 5/6 patients. After 7 years of follow-up, all patients achieved MS criteria with mild disability (mean EDSS 1.75; 0-4). Our literature review included 65 BCS patients from 30 studies: although CSF oligoclonal bands and the presence of additional MS lesions were associated with subsequent relapses, this was not significant. DISCUSSION/CONCLUSION Our series allows a detailed MRI description in BCS and gives a new insight into BCS evolution and its strong relationship with MS.
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Affiliation(s)
- Xavier Ayrignac
- Clinique de Sclérose en plaques du Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), and department of Neurosciences, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada; Département de Neurologie, CRC sclérose en plaques, CHU Montpellier, INSERM, Univ Montpellier, Montpellier, France.
| | - Laurent Letourneau-Guillon
- Département de Radiologie et Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Centre Hospitalier de l'Université de Montréal (CHUM), département de radiologie, radio-oncologie et médecine nucléaire, faculté de médecine, Université de Montréal, Montréal, Québec, Canada
| | - Clarisse Carra-Dallière
- Département de Neurologie, CRC sclérose en plaques, CHU Montpellier, INSERM, Univ Montpellier, Montpellier, France
| | - Pierre Duquette
- Clinique de Sclérose en plaques du Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), and department of Neurosciences, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Marc Girard
- Clinique de Sclérose en plaques du Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), and department of Neurosciences, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - José Poirier
- Clinique de Sclérose en plaques du Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), and department of Neurosciences, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Boaz Lahav
- Clinique de Sclérose en plaques du Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), and department of Neurosciences, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Catherine Larochelle
- Clinique de Sclérose en plaques du Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), and department of Neurosciences, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Alexandre Prat
- Clinique de Sclérose en plaques du Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), and department of Neurosciences, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
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