科研之友
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摘要
Balo is a rare demyelinating disease and a variant of multiple sclerosis. It is a self-limited disease that is not always fatal. Characteristic MR imaging findings may diagnose at the onset of the disease. We present a 19 year old girl with Balo disease with interesting presentation. Our case referred with fever and left hemiparesis following dental procedure 15 days ago. On physical examination fever about 38.5 degree and decrease in left limbs forces and muscular tones were noted. On CTscan a hypodense mass like area in RT parieto- frontal periventricular WM is detected. Following MRI the only findings was a low to iso signal T1 and high in T2 and flair concentric onion appearing partially enhancing mass lesion in parieto-frontal periventricular WM with mild edema and no hemorrhage. On diffusion weighted imaging no significant restriction was seen. Regarding to findings tumofactive MS, Low grade glioma, lymphoma, abcess and regarding to history and above findings abcess formation were in differential diagnosis. After intensive intravenous antibiothic and also modified steroid therapy and following MRI no improvement in clinical condition or MRI findings during 2months was occurred. Patient was undergone Stereotactic biopsy to differentiate probable tumoral lesion from abcess or tumofactive MS. Biopsy revealed Tumofactive Balo Ms. After 4 month intensive therapy patient discharged with normal and proper condition.No relapsing during one year later was detected.Our case was interesting because of interesting misleading clinical history and also typical MRI findings of Balo disease.
