NATIONAL ORGANIZATION RARE DISEASE

https://rarediseases.org/rare-diseases/balo-disease/
Balo Disease
Synonyms of Balo Disease

Concentric Sclerosis
Encephalitis Periaxialis Concentrica
Leukoencephalitis Periaxialis Concentric

General Discussion
Balo Disease is a rare and progressive variant of multiple sclerosis. It usually first appears in
adulthood, but childhood cases have also been reported. While multiple sclerosis typically is
a disease that waxes and wanes, Balo Disease is different in that it tends to be rapidly
progressive. Symptoms may include headache, seizures, gradual paralysis, involuntary
muscle spasms, and cognitive loss. The alternative names for Balo Disease, concentric
sclerosis or Balo concentric sclerosis, refer to the fact that Balo Disease is characterized by
bands of intact myelin (the sheath of fatty substances surrounding nerve fibers), alternating
with rings of loss of myelin (demyelination), in various parts of the brain and brain stem. The
symptoms of Balo Disease vary, according to the areas of the brain that are affected.
Symptoms may progress rapidly over several weeks or more slowly over two to three years.
Signs & Symptoms
Most cases are characterized by the gradual onset of symptoms that might be found in the
more common type of MS, including muscle spasms and paralysis. Other neurological
symptoms develop depending on the areas of the brain that are affected and may include
intellectual impairment and/or physiological abnormalities. However, in its most serious
form, Balo Disease may also suggest the presence of an infectious disease, starting with a
high fever and painful headaches.
Causes
The cause of MS and its variants remains unknown. However, some studies indicate that
autoimmune factors may play a role in the development of Balo Disease. Autoimmune

disorders are caused when the bodys natural defenses against foreign or invading
organisms (e.g., antibodies) begin to attack healthy tissue for unknown reasons.

Affected Populations
Balo Disease is a rare disorder that affects males and females in equal numbers. More cases
have been reported from China and the Philippines than elsewhere.
Related Disorders
Symptoms of the following disorders can be similar to those of Balo Disease. Comparisons
may be useful for a differential diagnosis:
Adrenoleukodystrophy is a rare inherited metabolic disorder characterized by the loss of the
fatty covering (myelin sheath) around nerve fibers in the brain (cerebral demyelination) and
the progressive degeneration of the adrenal gland. The symptoms of this disorder may include
generalized muscle weakness (hypotonia), exaggerated reflex responses (hyperreflexia),
impaired ability to coordinate movement (ataxia), spastic partial paralysis, and/or tingling or
burning sensations in the arms or legs. (For more information on this disorder, choose
Adrenoleukodystrophy as your search term in the Rare Disease Database.)
Multiple Sclerosis is a chronic disorder of the central nervous system (CNS) that causes the
destruction of the covering that surrounds nerve fibers (myelin sheath). The course of the
disease is variable. It may advance, relapse, remit, and/or stabilize. Symptoms may include
double vision (diplopia), involuntary rhythmic movements of the eyes (nystagmus), speech
impairment, numbness in the arms and legs, and/or difficulty walking. Impaired function of
the bowel and bladder may also be present. (For more information on this disorder, choose
Multiple Sclerosis as your search term in the Rare Disease Database.)
Canavans Leukodystrophy is a rare inherited type of leukodystrophy characterized by the
progressive degeneration of the central nervous system. Symptoms may include progressive
mental deterioration accompanied by increased muscle tone (hypertonia), poor head control,
an enlargement of the brain (megalocephaly), and/or blindness. Symptoms typically begin
during infancy. Early symptoms of Canavans Leukodystrophy may include general lack of
interest in daily living (apathy), muscle weakness and floppiness (hypotonia), and the loss of
previously acquired mental and motor skills. As the disease progresses, there may be spastic

muscle contractions of the arms and legs, lack of muscle strength in the neck, swelling of the
brain (megalocephaly), and paralysis. (For more information on this disorder, choose
Canavan as your search term in the Rare Disease Database.)
Metachromatic Leukodystrophy (MLD) is a rare inherited leukodystrophy characterized by
the abnormal accumulation of a fatty-like substance known as sulfatide in the tissues of the
nervous system and other organs. This results in the loss of the coverings on nerve fibers
(myelin sheath). Symptoms may include blindness, convulsions, muscle rigidity hypertonia)
and/or motor disturbances that may lead to paralysis and dementia. (For more information on
this disorder, choose Metachromatic Leukodystrophy as your search term in the Rare
Disease Database.)
Krabbes Leukodystrophy is a rare inherited metabolic disorder characterized by the
abnormal accumulation of a fatty substance (ceremide galactoside) in the brain. Symptoms
develop due to a deficiency of the enzyme galactoside beta-galactosidase. These may include
irritability, vomiting, episodes of partial unconsciousness, and/or seizures. There may also be
spastic contractions of the legs, difficulty swallowing, and mental deterioration. (For more
information on this disorder, choose Krabbe as your search term in the Rare Disease
Database.)
Alexanders Disease is an extremely rare, progressive metabolic disorder which is frequently
inherited. It is one of the sub-types of Leukodystrophy. Alexanders Disease is characterized
by the loss of fatty layers that cover nerve fibers (demyelination) and the formation of
abnormal fibers (Rosenthal) in the brain. The symptoms may include muscle spasms, mental
impairment, and/or growth delays. Most infants with Alexanders Disease have an
abnormally large head (megalencephaly), failure to thrive, and seizures. (For more
information on this disorder, choose Alexander as your search term in the Rare Disease
Database.)
Standard Therapies
Treatment is symptomatic and supportive. Corticosteroids are usually useful in decreasing
severity of acute presentations through their anti-inflammatory actions. Treatment to relieve
symptoms, such as spasticity, weakness, pain, or ataxia, includes pharmacologic and
rehabilitative modalities.

Penyakit Balo

Sinonim dari penyakit Balo

Konsentris Sclerosis
Ensefalitis Periaxialis Concentrica
Leukoencephalitis Periaxialis Konsentris

Diskusi Umum
Penyakit Balo adalah varian langka dan progresif multiple sclerosis. Biasanya pertama kali
muncul di usia dewasa, tetapi kasus-kasus kecil juga telah dilaporkan. Sementara multiple
sclerosis biasanya merupakan penyakit yang bertambah dan berkurang, Penyakit Balo
berbeda dalam hal itu cenderung cepat progresif. Gejala mungkin termasuk sakit kepala,
kejang, kelumpuhan bertahap, kejang otot tak sadar, dan kehilangan kognitif. Nama-nama
alternatif untuk Balo Penyakit, konsentris sclerosis atau Balo konsentris sclerosis, mengacu
pada fakta bahwa Penyakit Balo ditandai oleh band - band dari myelin utuh (selubung zat
lemak yang mengelilingi serabut saraf), bergantian dengan cincin kehilangan myelin
(demielinasi), di berbagai bagian otak dan batang otak. Gejala Penyakit Balo bervariasi,
sesuai dengan daerah otak yang terpengaruh. Gejala dapat berkembang pesat selama beberapa
minggu atau lebih lambat selama dua sampai tiga tahun.
Tanda & Gejala
Kebanyakan kasus yang ditandai dengan timbulnya bertahap gejala yang mungkin ditemukan
dalam jenis yang lebih umum dari MS, termasuk kejang otot dan kelumpuhan. gejala
neurologis lainnya mengembangkan tergantung pada area otak yang terpengaruh dan
mungkin termasuk gangguan intelektual dan / atau kelainan fisiologis. Namun, dalam bentuk
yang paling serius, Penyakit Balo juga menunjukkan adanya penyakit menular, dimulai
dengan demam tinggi dan sakit kepala yang menyakitkan.
Penyebab
Penyebab MS dan variannya masih belum diketahui. Namun, beberapa penelitian
menunjukkan bahwa faktor autoimun mungkin memainkan peran dalam perkembangan

Penyakit Balo. Gangguan autoimun disebabkan ketika pertahanan alami tubuh terhadap
organisme "asing" atau menyerang (misalnya, antibodi) mulai menyerang jaringan sehat
untuk alasan yang tidak diketahui.

Populasi yang terkena dampak

Penyakit Balo adalah gangguan langka yang mempengaruhi pria dan wanita dalam jumlah
yang sama. kasus lebih telah dilaporkan dari China dan Filipina daripada di tempat lain.
Gangguan terkait
Gejala gangguan berikut dapat mirip dengan penyakit Balo. Perbandingan mungkin berguna
untuk diagnosis diferensial:
Adrenoleukodystrophy adalah kelainan langka mewarisi metabolisme yang ditandai dengan
hilangnya penutup lemak (selubung mielin) di sekitar serat saraf di otak (cerebral
demielinasi) dan degenerasi progresif dari kelenjar adrenal. Gejala-gejala gangguan ini
meliputi umum kelemahan otot (hipotonia), respon refleks berlebihan (hyperreflexia),
gangguan kemampuan untuk mengkoordinasikan gerakan (ataksia), kelumpuhan parsial
spastik, dan / atau kesemutan atau sensasi terbakar di lengan atau kaki. (Untuk informasi
lebih lanjut tentang gangguan ini, pilih "adrenoleukodystrophy" sebagai istilah pencarian
Anda di Rare Disease Database.)
Multiple Sclerosis adalah gangguan kronis dari sistem saraf pusat (SSP) yang menyebabkan
kehancuran meliputi yang mengelilingi serabut saraf (mielin selubung). Perjalanan penyakit
adalah variabel. Mungkin maju, kambuh, mengirimkan, dan / atau menstabilkan. Gejala
mungkin termasuk penglihatan ganda (diplopia), gerakan ritmis involunter dari mata
(nystagmus), gangguan berbicara, mati rasa di lengan dan kaki, dan / atau kesulitan berjalan.
Gangguan fungsi usus dan kandung kemih juga dapat hadir. (Untuk informasi lebih lanjut
tentang gangguan ini, pilih "Multiple Sclerosis" sebagai istilah pencarian Anda di Rare
Disease Database.)

Canavan Leukodystrophy adalah jenis mewarisi langka leukodystrophy ditandai

dengan degenerasi progresif dari sistem saraf pusat. Gejala mungkin termasuk

kerusakan progresif mental yang disertai dengan peningkatan otot nada (hypertonia),
kontrol kepala yang buruk, pembesaran otak (megalocephaly), dan / atau kebutaan.
Gejala biasanya dimulai selama masa bayi. Gejala awal dari Canavan Leukodystrophy
mungkin termasuk kurangnya minat dalam hidup sehari-hari (apatis), kelemahan otot
dan floppiness (hypotonia), dan hilangnya kemampuan mental dan motorik yang
diperoleh sebelumnya. Sebagai penyakit berlangsung, mungkin ada kontraksi spastik
otot pada lengan dan kaki, kurangnya kekuatan otot di leher, pembengkakan otak
(megalocephaly), dan kelumpuhan. (Untuk informasi lebih lanjut tentang gangguan
ini, pilih "Canavan" sebagai istilah pencarian Anda di Rare Disease Database.)

Metachromatic Leukodystrophy (MLD) adalah leukodystrophy diwariskan langka

yang ditandai dengan akumulasi abnormal zat lemak seperti yang dikenal sebagai
sulfatide dalam jaringan sistem saraf dan organ lainnya. Hal ini menyebabkan
hilangnya penutup pada serabut saraf (mielin selubung). Gejala mungkin termasuk
kebutaan, kejang, otot kekakuan hypertonia) dan / atau gangguan motor yang dapat
menyebabkan kelumpuhan dan demensia. (Untuk informasi lebih lanjut tentang
gangguan ini, pilih "metachromatic Leukodystrophy" sebagai istilah pencarian Anda
di Rare Disease Database.)

Krabbe ini Leukodystrophy adalah gangguan metabolisme langka bawaan yang

ditandai oleh akumulasi abnormal zat lemak (ceremide galaktosida) di otak. Gejala
berkembang karena kekurangan enzim galaktosida beta-galaktosidase. Ini mungkin
termasuk lekas marah, muntah, episode pingsan parsial, dan / atau kejang. Mungkin
juga ada kontraksi spastik dari kaki, kesulitan menelan, dan penurunan mental. (Untuk
informasi lebih lanjut tentang gangguan ini, pilih "Krabbe" sebagai istilah pencarian
Anda di Rare Disease Database.)

Alexander Penyakit adalah gangguan yang sangat langka, progresif metabolik yang
sering diwariskan. Ini adalah salah satu sub-jenis Leukodystrophy. Alexander
Penyakit ini ditandai dengan hilangnya lapisan lemak yang menutupi serabut saraf
(demielinasi) dan pembentukan serat abnormal (Rosenthal) di otak. Gejala mungkin
termasuk kejang otot, gangguan mental, dan / atau keterlambatan pertumbuhan.
Kebanyakan bayi dengan Alexander Penyakit memiliki kepala normal besar
(megalencephaly), gagal tumbuh, dan kejang. (Untuk informasi lebih lanjut tentang

gangguan ini, pilih "Alexander" sebagai istilah pencarian Anda di Rare Disease
Database.)
Standar Terapi
Pengobatan simtomatik dan suportif. Kortikosteroid biasanya berguna dalam mengurangi
keparahan presentasi akut melalui tindakan anti-inflamasi. Pengobatan untuk meredakan
gejala, seperti spastisitas, kelemahan, nyeri, atau ataksia, termasuk farmakologis dan
rehabilitatif modalitas.
References
TEXTBOOKS
Giesser BS. Rare Variants of Multiple Sclerosis. In: NORD Guide to Rare Disorders.
Lippincott Williams & Wilkins. Philadelphia, PA. 2003:560.
Adams RD, Victor M, Ropper AA. Eds. Principles of Neurology. 6th ed. McGraw-Hill
Companies. New York, NY; 1997:915.
Menkes JH, Pine Jr JW, et al. Eds. Textbook of Child Neurology. 5th ed. Williams & Wilkins.
Baltimore, MD; 1995:535.
REVIEW ARTICLES
Dupel-Pottier C. [Diagnostic criteria of borderline forms of multiple sclerosis] Rev Neurol
(Paris). 2001;157(8-9 Pt 2):935-43. French
Fontaine B. [Borderline forms of multiple sclerosis] Rev Neurol (Paris). 2001;157(8-9 Pt
2):929-34. French
Moser HW. Neurometabolic disease. Curr Opin Neurol. 1998;11:91-95.
JOURNAL ARTICLES
Moore GR, Berry K, Oger JJ, et al. Balos concentric sclerosis: surviving normal myelin in a
patient with relapsing-remitting clinical course. Mult Scler. 2001;7:375-82.
Kastrup O, Stude P, Limmroth V. Balos concentric sclerosis. Evolution of active
demyelination demonstrated by serial contrast-enhanced MRI. J Neurol. 2002;249:811-14.

Karaaslan E, Altintas A, Senol U, et al. Balos concentric sclerosis: clinical and radiological
features of five cases. AJNR Am J Neuroradiol. 2001;22:1362-67.
Chen CJ. Serial proton magnetic resonance spectroscopy in lesions of Balos concentric
sclerosis. J Comput Assist Tomogr. 2001;25:713-18.
Caracciolo JT, Murtagh RD, Rojiani AM, et al. Pathognomic MR imaging in Balo concentric
sclerosis. AJNR Am J Neuroradiol. 2001;22:292-93.
Iannucci G, Mascalchi M, Salvi F, et al. Vanishing Balo-like lesions in multiple sclerosis. J
Neurol Neurosurg Psychiatry. 2000;69:399-400.
Singh S, Kuruvilla A, Alexander M, et al. Balos concentric sclerosis: value of magnetic
resonance imaging in diagnosis. Australas Radiol. 1999;43:400-04.
Chen CJ, Chu NS, Lu CS, et al. Serial magnetic resonance imaging in patients with Balos
concentric sclerosis: natural history of lesion development. Ann Neurol. 1999;46:651-56.

FROM THE INTERNET

Balo Disease. nd. 1p.
www.kovaidoctors.com/diseases/b/b4.php
What is Multiple Sclerosis? Last Modified; 12/20/2002:4pp.
www.mult-sclerosis.org/whatisms.html
How does Multiple Sclerosis do its damage? Last Modified; 11/27/2002:4pp.
www.mult-sclerosis.org/howms.html