BALOS CONCENTRIC SCLEROSIS - A CLINICAL CASE-STUDY OF BRAIN MRI, BIOPSY, AND PROTON MAGNETIC-RESONANCE SPECTROSCOPIC FINDINGS

The antemortem diagnosis of Balo's concentric sclerosis was made in a 52 year old woman with subacute right hemiparesis on the basis of brai n MRI and stereotactic brain biopsy, which showed multiple ring-like l esions of lamellated demyelination alternating with spared white matte r. Proton magnetic resonance spectroscopy (1H-MRS) was carried out one and nine months after the onset of illness. The first H-1-MRS showed a decreased N-acetyl aspartate peak, an increased choline peak, presen ce of large lipid peaks, and high resonance at 1.4 ppm. The second H-1 -MRS disclosed changes such as a decrease of lipid signal, a decrease of resonance at 1.4 ppm, and an increase in the myoinositol peak. Thes e findings are similar to those reported for multiple sclerosis. It se ems that this is the first report of H-1-MRS findings in Bale's concen tric sclerosis.