Baló Concentric Sclerosis Mimicking Encephalitis with Seizures and Progressive Aphasia in a 26-Year-Old Woman: A Challenging Diagnostic Dilemma

Nexhmedin Shala; Ilir Tolaj; Fisnik Jashari; Edita Malazogu; Argjend Shala; Gentiant Bajraktari; Ilir Ahmetgjekaj; Shemsedin Dreshaj

doi:10.1159/000534358

Baló Concentric Sclerosis Mimicking Encephalitis with Seizures and Progressive Aphasia in a 26-Year-Old Woman: A Challenging Diagnostic Dilemma

Case Rep Neurol. 2023 Oct 6;15(1):227-232. doi: 10.1159/000534358. eCollection 2023 Jan-Dec.

Authors

Nexhmedin Shala¹, Ilir Tolaj², Fisnik Jashari¹, Edita Malazogu¹, Argjend Shala¹, Gentiant Bajraktari³, Ilir Ahmetgjekaj⁴, Shemsedin Dreshaj⁵

Affiliations

¹ Department of Neurological Diseases, University Clinical Centre, Pristina, Kosovo.
² Department of Infectious Diseases, Medical Faculty, Pristina, Kosovo.
³ Department of Ophthalmology, University Clinical Centre, Pristina, Kosovo.
⁴ Department of Radiology, University Clinical Centre, Pristina, Kosovo.
⁵ Department of Infectious Diseases, University Clinical Centre, Pristina, Kosovo.

Abstract

Introduction: Baló's concentric sclerosis (BCS) is a rare subtype of multiple sclerosis characterized by inflammatory demyelination within the central nervous system.

Case presentation: This case report presents a challenging diagnostic scenario involving a 26-year-old woman diagnosed with BCS. Despite treatment, her condition did not ameliorate, and magnetic resonance imaging (MRI) findings remained unchanged. A subsequent stereotactic biopsy revealed tumefactive Balo disease, highlighting the intricate diagnostic and therapeutic issues surrounding BCS.

Conclusion: The juxtacortical location of the BCS lesion, as observed in our case, suggests an unfavourable prognosis due to treatment-resistant seizures.

Keywords: Aphasia; Baló concentric sclerosis; Diagnostic dilemma; Encephalitis; Seizures.

Publication types

Case Reports

Grants and funding

No funding is required for this case report.