BALO CONCENTRIC SCLEROSIS DIAGNOSED INTRAVITAM ON BRAIN BIOPSY

A 28-year-old woman presented with acute right hemiparesis evolving to bilateral hemiplegia and a mute state within 1 week on a background o f paranoid psychosis of 8 years duration. CT scan revealed multiple bi lateral hypodense enhancing lesions in the central white matter. Biops y of the lesion showed lamellar alternating zones of demyelination and remyelination, typical of Balo's concentric sclerosis, an acute varia nt of multiple sclerosis. Immunohistochemical staining for neurofilame nt showed greater damage to the axis cylinders by the disease than gen erally perceived by silver stains. Steroid therapy produced a gratifyi ng and sustained improvement. Follow up CT scans and psychometry revea led regression of the demyelinating lesions and improvement of the cog nitive state.