Updated 28/08/2026
Photo: High-Tech Medicine, by Muffet (Flickr), cropped for layout · Licensed CC BY 2.0 · Source · Illustrative image, not the patient/participants discussed.
Plain-language summary of research published in the Georgian Medical Journal. Written for the general public by the GMJ News editorial team.
A 17-year-old male arrived at the emergency department with sudden right-sided weakness and an unsteady gait — a presentation that, on its face, looked exactly like a stroke. A case report in the Georgian Medical Journal documents how the real diagnosis turned out to be far rarer: Baló concentric sclerosis, an unusual variant of demyelinating disease that can evolve into multiple sclerosis.
A Diagnosis That Mimics Stroke
Baló concentric sclerosis has a characteristic neuroradiological appearance — concentric, ring-like layers of demyelination on brain imaging — but its clinical presentation varies widely, ranging from benign to aggressive (“malignant”) forms, and the underlying immunology remains poorly characterised even in the specialist literature. In this case, the patient, a 17-year-old Caucasian male from Kazakhstan, presented with acute focal neurological deficits — right-sided hemiparesis (weakness) and gait unsteadiness — that initially pointed toward acute ischaemic stroke, a far more common diagnosis in an emergency setting.
What the Imaging Revealed
Brain MRI told a different story: multifocal lesions in the thalamus and the temporal and parietal lobes, with pronounced diffusion restriction — imaging findings that, taken together, confirmed Baló concentric sclerosis rather than stroke. Following treatment with high-dose intravenous methylprednisolone (a corticosteroid), the patient showed rapid neurological improvement.
At a glance — the study’s headline figures.
The story didn’t end there. A subsequent relapse led to a revised diagnosis of relapsing-remitting multiple sclerosis (RRMS), and the patient was started on ocrelizumab, a disease-modifying therapy, with a satisfactory response. The case demonstrates that this particular pattern of demyelination — known as Pattern I — can underlie atypical presentations that go on to evolve into classical multiple sclerosis.
For clinicians, the practical lesson is a diagnostic one: an adolescent or young adult presenting with acute, stroke-like focal neurological deficits deserves imaging sharp enough to distinguish rare demyelinating variants from vascular events — because the treatment path, and the long-term disease trajectory, diverge completely depending on which one it actually is.
Read the Original Research
Original article: When MS Looks Like Something Else: A Case of Baló Concentric Sclerosis
Published in: Georgian Medical Journal, Vol. 1 No. 3 (2026)
DOI: 10.66636/gmj.v1.i3.a180
📄 Read the full article at gmj.ge →
Georgian Medical Journal (GMJ) · ISSN 3088-4322 · gmj.ge · Open Access CC BY 4.0 · Published by the Public Health Institute of Georgia (PHIG). This summary is an independent editorial product of GMJ News; for clinical decisions, consult the original peer-reviewed article and a qualified professional.
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