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While Balo’s Disease can be distinguished from multiple sclerosis with some tests, it’s very similar from the start. Symptoms are almost identical in many cases.

The symptoms and complications of multiple sclerosis come in such a wide variety the list is extremely long, and that means each individual with the disease has a very different experience. With these differences, it’s easy for other ailments to appear as though they are the early stages of multiple sclerosis, which is why the testing to diagnose MS is so stringent.

But what if another disease almost completely mirrors MS? With Balo’s Disease, the symptoms are so similar that doctors sometimes treat Balo’s Disease as if it is a rare type of MS. There are more similarities between the two than with most other diseases and MS. However, the differences are quite distinct, making them obviously two very separate diseases.

 

What is Balo’s disease?

Perhaps the initial comparison comes from the fact that Balo’s Disease essentially begins the same way as multiple sclerosis. What is believed to be an autoimmune attack on the central nervous system (CNS – the brain, spinal cord, and optic nerve) causes damage to the myelin, or protein coating that protects the nerves in the CNS and helps messages travel faster through the nerves.

Balo’s Disease is also sometimes referred to as Balo’s Concentric Sclerosis because, when lesions appear on the brain and spinal cord in the disease, the resulting damage appears on scans as concentric rings, like a bullseye target. This is the alternation of healthy, intact myelin and areas of myelin loss (or demyelination).

MS vs Balo's disease: Symptoms and similarities

Those bold enough to call Balo’s Disease a variant of multiple sclerosis do have good reason to link the two. After all, most of the symptoms in the early stages of the two diseases are identical:

  • Muscle weakness, pain, and spasms
  • Headaches, usually frequent
  • Trouble speaking or swallowing
  • Changes in behavior and cognition
  • Seizures (not common in MS but consistently arising in some patients)

Both diseases are believed to be based on autoimmune attacks against myelin, though there is no determined reason for the body to have this overreaction. Both are progressive, with the symptoms of MS often reaching a point at which they do not go away and start to worsen. In Balo’s Disease, the symptoms usually progress rapidly from their first appearance without letup.

Unfortunately, there are some vast differences in treatment options and the way the diseases progress and affect everyday life beyond that.

MS and Balo's disease: The differences

One major difference in MS and Balo’s Disease is the way it presents in the body. While multiple sclerosis shows no sort of pattern in the damage done to the nerves of the brain and spinal cord, appearing only as spots, Balo’s disease appears on scans as concentric circles that look like a target, which is why it’s sometimes called Balo’s concentric sclerosis.

Other differences are numerous, such as:

  1. While multiple sclerosis can cause difficulty in moving, it doesn’t often lead to complete paralysis, when patients keep up with physical and occupational therapy. However, Balo’s Disease sees paralysis of certain parts of the body frequently as a symptom, usually starting in extremities and progressing.
  2. With MS, most patients have relapses of symptoms that then disappear for an extended time – anywhere from weeks to years – allowing recovery time and often not growing more significant with each relapse. For most patients, progression of the disease is slow. However, with Balo’s disease, there is a more gradual onset of symptoms, and it begins advancement from onset, with speed of progression lasting anywhere from weeks to two or three years.
  3. While neither disease has a cure, multiple sclerosis can be treated in a number of ways, with multiple medications, ranging from anti-inflammatory agents to immunosuppressants and even chemotherapy. Unfortunately, Balo’s Disease has no approved medication for treatment, and doctors often prescribe treatment with corticosteroids to manage the inflammation caused by the disease, perhaps aided by pain medication.
  4. Multiple sclerosis is most prevalent in Caucasian women, with the lowest number of cases presenting in races from the Asian continent. Balo’s Disease, however, is most commonly diagnosed in people from China or the Philippines, with men and women at equal risk.
  5. While MS can be diagnosed at any age, it is most commonly developed between the ages of eighteen and forty, with more cases beginning on the younger end of that range. Balo’s disease is typically diagnosed in patients in their thirties, though there is no technical age limitation in diagnosing the disease.
  6. While multiple sclerosis affects all parts of the central nervous system (CNS) with seemingly random attacks, Balo’s disease is more focused on the brain and brain stem than the rest of the spinal cord. It does, on occasion, cause damage to the optic nerve as well.
  7. In most cases, cognitive symptoms of multiple sclerosis are mild and temporary, and they don’t usually lead to permanent intellectual impairment. However, this is common in Balo’s Disease patients.
  8. While inflammation can cause some fever in MS patients, elevated temperature doesn’t typically accompany the disease, except when overheated due to overexertion, lack of airflow, or extreme heat outdoors. In patients with Balo’s disease, serious cases can present with high fever and painful headaches as the patient might experience with an infection.

Conclusion

While Balo’s Disease can be distinguished from multiple sclerosis with some tests, it’s very similar from the start. Symptoms are almost identical in many cases, and because MS has so many symptoms, it’s easy for other diseases like Balo’s to mimic it. However, to assure that the patient receives proper treatment, especially since MS can be treated in a way that eases symptoms and slows progression, it’s vital to go through the rigorous testing process to eliminate other culprits before diagnosing either disease.

Consulting a physician leads to a family history, a physical exam, and then a battery of tests that include drawing blood, taking an MRI, a spinal tap (where fluid is taken from the spinal cord to measure presence of certain proteins and antibodies), and possibly an evoked potential (EP) test, which measures brain activity during certain types of stimulation. It sounds extensive, but it’s necessary to make the determination.

  • rarediseases.org/rare-diseases/balo-disease/
  • https://www.nationalmssociety.org/What-is-MS/Related-Conditions/Balo’s-Disease
  • https://www.nationalmssociety.org/What-is-MS/Related-Conditions/Balo’s-Disease/Symptoms-and-Diagnosis
  • Photo courtesy of SteadyHealth.com

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