Baló's disease: symptoms, causes and treatment

Baló's disease is a rare neurological disease, similar to multiple sclerosis, which affects the myelin in the brain and produces symptoms such as muscle spasms, paralysis or seizures. It is a very disabling disease and to this day there is no cure.

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.

• Related article: "The 15 most frequent neurological disorders"

What is Balo'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 myelin, the protective layer of axons, is damaged), considered a variant of multiple sclerosis.

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

Generally, Baló's disease presents acutely and affects, as occurs with multiple sclerosis, young adults,

with a rapid progression until the person dies. However, cases have also been reported in which there has been a progressive course, remissions partial and even total, both spontaneously and followed by therapeutic treatments conventional.

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

• You may be interested in: "Myelin: definition, functions and characteristics"

Causes and diagnosis

Although to this day the causes of Baló's disease and its variants are unknown, there are studies that indicate that autoimmune factors may play a prominent role in its development.

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

Nor are the causes of the recovery observed in some patients who have received, or not, the indicated treatment for Baló's disease currently known, so in this sense there is still much to investigate.

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 already possible.

Professionals often rely on consistent and specific clinical signs and symptoms, trying to exclude other neurological diseases. Concentric rings characteristic of this disease can be observed on magnetic resonance imaging.

symptoms of the disease

The characteristic symptoms of Baló'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 plaques that spread out in a series of concentric circles, as we 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.

The symptoms caused by Baló's disease can be very disabling for the person who suffers from them and can threaten severely affect his life, progressing rapidly in a few weeks or, conversely, evolving more slowly over 2 or 3 years.

Treatment

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

The usual treatment is the same as that applied to people who suffer from multiple sclerosis flare-ups.; that is, consumption of high-dose corticosteroids 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 rehabilitation modalities. However, Baló's disease has a fatal course and lacks episodes of exacerbation and remission, as occurs in multiple sclerosis.

Related disorders

Baló's disease shares symptoms with another series of neurological diseases, which is why it is important to know what they are in order to make a proper diagnosis.

1. adrenoleukodystrophy

It 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), 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 the destruction of myelin or brain demyelination.

The course of the disorder is variable, since the patient may relapse, remit symptoms or stabilize. Symptoms of this disease include double vision (diplopia), involuntary rhythmic movements of eyes (nystagmus), impaired speech, numbness in 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 decline accompanied by increased muscle tone (hypertonia), an enlarged brain (megalocephaly), poor head control and/or blindness.

Symptoms usually start during childhood 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's disease

Alexander disease is an extremely rare progressive metabolic disorder that 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 delayed growth. Most babies with Alexander disease have an abnormally large head (megalencephaly), failure to thrive, and seizures.

Bibliographic references:

• Karaaslan E, Altintas A, Senol U, et al. Balo's concentric sclerosis: 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. Balo's concentric sclerosis: a variant of multiple sclerosis associated with oligodendroglioma. Neurosurgery 1989;25:982-986