Ballo’s disease: symptoms, causes and treatment

Baló concentric sclerosis is a disease that destroys the myelin of neurons.

Baló's disease is a rare neurological disease, similar to multiple sclerosis, which affectssimilar to multiple sclerosis, which affects the myelin of the brain and produces symptoms such as muscle spasms, paralysis or seizures. It is a very disabling disease that has no cure to date.

In this article we explain in more detail what the disease consists of, what its causes are, the symptoms it causes and the usual treatment indicated.

What is Baló's disease?

Baló's disease or Baló's concentric sclerosis was described in 1928 by the Hungarian physician Jozsef Baló. It is a rare demyelinating disease (in which the myelin, the protective layer of the axons, is damaged), considered a variant of multiple sclerosis.

The term "concentric sclerosis" is due to the presence of a pattern of concentric areas in the axons. a pattern of concentric (circular) areas of damaged myelin alternating with areas of myelinated alternating with areas of relatively intact myelin in various areas of the brain and spinal cord.

Ballo disease usually presents acutely and, as with multiple sclerosis, affects young adults, with a rapid progression until the person dies.. However, cases have also been reported in which there has been a progressive course, partial and even total remissions, both spontaneously and followed by conventional therapeutic treatments.

This rare disease affects both men and women equally, and its incidence seems to be more common in people with its incidence seems to be more common in people of oriental origin.mainly originating from countries such as China and the Philippines.

Causes and diagnosis

Although the causes of Ballo disease and its variants are currently unknown, studies indicate that autoimmune factors may play a major role in its development. autoimmune factors may play a prominent role in its development..

Autoimmune disorders occur when the body's natural defenses against foreign or invading organisms begin to attack healthy tissue for unknown reasons, causing inflammation (swelling).

The causes of the recovery observed in some patients who have, or have not, received the indicated treatment for Baló's disease are also currently unknown. much research remains to be done.

Years ago, the diagnosis of this disease was obtained after an autopsy of the deceased patient. However, today, with new neuroimaging techniques, earlier detection of the disorder is now possible.

Professionals usually rely on consistent and specific clinical signs and symptoms, trying to exclude other neurological diseases.The neuroimaging techniques are often based on consistent and specific clinical signs and symptoms, trying to exclude other neurological diseases. The concentric rings characteristic of this disease can be seen on magnetic resonance imaging.

Symptoms of the disease

The characteristic symptoms of Baló's disease vary depending on which areas of the brain are affected. Demyelinating lesions in the brain can be located in any area (cerebrum, cerebellum or brainstem). (cerebrum, cerebellum or brain stem).

The sessions usually consist of irregular demyelinating plaques that extend in a series of concentric circles, as mentioned at the beginning. The symptoms caused by the disease are very varied: persistent headache, progressive paralysis, involuntary muscle spasms, seizures, intellectual disability, and cognitive loss or impairment. and cognitive loss or impairment.

The symptoms caused by Ballo disease can be very disabling for the sufferer and can be severely life-threatening, progressing rapidly over a few weeks or, conversely, evolving more slowly over 2 to 3 years.

Treatment

Due to the low incidence of a disorder such as Baló's disease and the limited number of cases described, no systematized studies have been carried out for the treatment of the disease.

The usual treatment is the same as that applied to people suffering from multiple sclerosis flares, i.e., corticosteroids.i.e., consumption of corticosteroids at high doses to reduce the severity in acute presentations, through their Anti-Inflammatory actions. The use of immunosuppressive drugs seems to be indicated because of the associated poor prognosis.

Treatment to alleviate symptoms such as spasticity, weakness, pain or ataxia, includes pharmacological and rehabilitative modalities.. However, Baló's disease has a fatal course and lacks episodes of exacerbation and remission, as is the case in multiple sclerosis.

Related disorders

Ballo disease shares symptoms with a number of other neurological diseases, so it is important to know what they are in order to make a proper diagnosis.

1. Adrenoleukodystrophy

It is a rare inherited metabolic disorder that is characterized by cerebral demyelination and progressive degeneration of the adrenal gland..

Symptoms of this disorder include: generalized muscle weakness (hypotonia), exaggerated reflex responses (hyperreflexia), impaired ability to coordinate movements (ataxia), spastic partial paralysis and/or tingling or burning sensations in the arms or legs.

2. Multiple sclerosis

Multiple sclerosis is a disease of the central nervous system that causes destruction of myelin or cerebral demyelination.

The course of the disorder is variable, since the patient may relapse, remit symptoms or become stable.. Symptoms of this disease include double vision (diplopia), involuntary rhythmic eye movements (nystagmus), impaired speech, numbness of the arms and legs, difficulty walking, etc.

3. Canavan leukodystrophy

It is a rare hereditary type of leukodystrophy characterized by progressive degeneration of the central nervous system. Symptoms include progressive mental deterioration accompanied by increased muscle tone (hypertonia), enlargement of the brain (megalocephaly), poor head control and/or blindness.

Symptoms usually begin during infancy and may include a general lack of interest in daily life (apathy), muscle weakness (hypotonia), and loss of previously acquired mental and motor skills. As the disease progresses, there may be spastic muscle contractions in the arms and legs, lack of muscle strength in the neck, swelling of the brain (megalocephaly) and paralysis.

4. Alexander disease

Alexander disease is an extremely rare progressive metabolic disorder, which is frequently inherited. It is one of the subtypes of leukodystrophy. This disorder is characterized by demyelination and the formation of abnormal fibers (Rosenthal fibers) in the brain.

Symptoms of this disease may include muscle spasms, mental impairment, and/or growth retardation.. Most infants with Alexander disease have an abnormally large head (megalencephaly), failure to thrive, and seizures.

Literature references:

• Karaaslan E, Altintas A, Senol U, et al. Concentric sclerosis of Balo: clinical and radiologic features of five cases. AJNR Am J Neuroradiol. 2001; 22: 1362-67
• Shankar SK, Rao TV, Srivastas VK, Narula S, Asha T, Das S. Balo's concentric sclerosis: a variant of multiple sclerosis associated with oligodendroglioma. Neurosurgery 1989;25:982-986.