Nandini M, Gourie-Devi M, Shankar S K, Mustare V B, Ravi V
Department of Neurology, National Institute of Mental Health and Neuro Sciences, Bangalore, India.
Clin Neurol Neurosurg. 1993 Dec;95(4):303-9. doi: 10.1016/0303-8467(93)90106-q.
A 28-year-old woman presented with acute right hemiparesis evolving to bilateral hemiplegia and a mute state within 1 week on a background of paranoid psychosis of 8 years duration. CT scan revealed multiple bilateral hypodense enhancing lesions in the central white matter. Biopsy of the lesion showed lamellar alternating zones of demyelination and remyelination, typical of Balo's concentric sclerosis, an acute variant of multiple sclerosis. Immunohistochemical staining for neurofilament showed greater damage to the axis cylinders by the disease than generally perceived by silver stains. Steroid therapy produced a gratifying and sustained improvement. Follow up CT scans and psychometry revealed regression of the demyelinating lesions and improvement of the cognitive state.
一名28岁女性，有8年偏执型精神病病史，1周内出现急性右侧偏瘫，随后发展为双侧偏瘫及缄默状态。CT扫描显示双侧中央白质有多个低密度强化病灶。病灶活检显示为脱髓鞘和再髓鞘化交替的板层状区域，这是巴洛同心性硬化的典型表现，巴洛同心性硬化是多发性硬化的一种急性变异型。神经丝免疫组化染色显示，与银染通常所见相比，该疾病对轴突的损伤更大。类固醇治疗取得了令人满意且持续的改善效果。后续的CT扫描和心理测试显示脱髓鞘病灶消退，认知状态改善。
