MRI features of Bale's concentric sclerosis

We report MRI findings in a 56-year-old woman with Bale's concentric sclero sis (BCS) who initially presented with a progressive hemiparesis. MRI showe d two lesions with a concentric pattern in the left frontoparietal region a nd a laminated, arcuate pattern in the right frontal region. These patterns were best seen in post-contrast images and were consistent with BCS. In ad dition, there were several small cerebral multiple sclerosis-like plaques. The clinical symptoms improved and the MR findings regressed after corticos teroid therapy. The patient had completely recovered 12 months later, excep t for mild right hand numbness. MRI showed further regression of the lesion s, but the concentric pattern was still present. This case demonstrated tha t BCS can run a benign prolonged course and may persist for a long time. Co ncentric or laminated contrast enhancement in the acute phase may suggest t hat bands of demyelination in BCS occur synchronously rather than successiv ely.