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Balo's concentric sclerosis

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  • A 40-year-old patient presented with right-sided sensory disturbance. Initial MRI showed a T2-hyperintense lesion in the left precentral gyrus with a rim of diffusion restriction and subtle enhancement.
  • Despite steroid therapy, an MRI one month later showed that the lesion has significantly enlarged although the enhancement resolved.
  • After two months, following plasma exchange, the lesion had decreased in size although punctate enhancement had developed.