Ballo’s disease is a rare neurological disease , similar 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 and has no cure at present.
In this article we explain in more detail what the disease is, what its causes are, the symptoms it causes and the usual treatment indicated.
What is Balo’s disease?
Baló’s disease or concentric Baló’s 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 to be a variant of multiple sclerosis.
The term “concentric sclerosis” is due to the presence of a pattern of concentric (circular) areas of damaged myelin alternating with relatively intact areas of myelin in various areas of the brain and spinal cord.
Generally, Ballo’s disease is acute and affects, as with multiple sclerosis, young adults, with rapid progression until the person dies . However, cases have also been reported in which a progressive course, partial and even total remissions have occurred, both spontaneously and followed by conventional therapeutic treatments.
This rare disease affects men and women equally, and its incidence appears to be more common in people of eastern origin , especially those from countries such as China and the Philippines.
Causes and Diagnosis
Although at present the causes of Baló’s disease and its variants are unknown, there are studies that indicate that autoimmune factors can play a prominent role in its development .
Autoimmune disorders occur when the body’s natural defenses against foreign or invasive organisms begin to attack healthy tissue for unknown reasons, causing inflammation (swelling).
Neither are the causes of the recovery observed in some patients who have or have not received the indicated treatment for Baló’s disease known at present, so in this sense there is still much to be investigated .
Years ago, the diagnosis of this disease was obtained after performing an autopsy on the deceased patient. However, today, with new neuroimaging techniques, earlier detection of the disorder is possible.
Professionals usually rely on consistent and specific clinical signs and symptoms , trying to exclude other neurological diseases. The characteristic concentric rings of this disease can be seen on the MRI.
Symptoms of the disease
The characteristic symptoms of Ballo’s disease vary depending on the areas of the brain that are affected. Demyelinating lesions in the brain can be located in any area (brain, cerebellum or brain stem).
The sessions usually consist of irregular demyelination plates that extend in a series of concentric circles, as we discussed at the beginning. The symptoms caused by the disease are very varied: persistent headache, progressive paralysis, involuntary muscle spasms, convulsions, intellectual disability and cognitive loss or impairment.
The symptoms caused by Ballo’s disease can be very disabling for the person who suffers it and can seriously threaten his life, progressing rapidly in a few weeks or, conversely, evolving more slowly over 2 or 3 years.
Due to the low incidence of a disorder such as Ballo’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 outbreaks of multiple sclerosis ; that is, consumption of corticosteroids at high doses to reduce the severity of acute presentations, through their anti-inflammatory actions. The use of immunosuppressive drugs seems to be indicated by the associated poor prognosis.
Treatment to relieve symptoms such as spasticity, weakness, pain or ataxia, includes pharmacological and rehabilitative modalities . However, Ballo’s disease has a fatal course and lacks episodes of exacerbation and remission, as it does in multiple sclerosis.
Ballo’s 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.
Thixagemia is a rare inherited metabolic disorder 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), partial spastic 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, as the patient may relapse, remit symptoms or stabilize . The symptoms of this disease include double vision (diplopia), involuntary rhythmic movements of the eyes (nystagmus), impaired speech, numbness of the arms and legs, difficulty walking, etc.
3. Canavan leukodystrophy
It is a rare hereditary type of leukodystrophy that is characterized by progressive degeneration of the central nervous system. Symptoms include progressive mental deterioration accompanied by increased muscle tone (hypertonia), brain enlargement (megalocephaly), poor head control and/or blindness.
Symptoms usually begin during childhood and may include a general lack of interest in daily life (apathy), muscle weakness (hypotonia) and the 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’s disease
Alexander’s disease is an extremely rare progressive metabolic disorder, which is often 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 decline and/or growth retardation . Most infants with Alexander’s disease have an abnormally large head (megalencephaly), failure to thrive, and seizures.
- Karaaslan E, Altintas A, Senol U, et al. Concentric sclerosis of Balo: clinical and radiological characteristics of five cases. AJNR Am J Neuroradiol. 2001; 22: 1362-67
- Shankar SK, Rao TV, Srivastas VK, Narula S, Asha T, Das S. La esclerosis concéntrica de Balo: una variante de la esclerosis múltiple asociada al oligodendroglioma. Neurocirugía 1989;25:982-986