Japanese Society of Internal Medicine, Internal Medicine, 5(53), p. 529-529, 2014
DOI: 10.2169/internalmedicine.53.1395
Japanese Society of Internal Medicine, Internal Medicine, 13(52), p. 1517-1521, 2013
DOI: 10.2169/internalmedicine.52.9330
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A 34-year-old woman developed simultaneous bilateral severe optic neuritis and subsequent myelitis. Two months after the first attack, she developed a headache and dysesthesia in the left arm. Brain magnetic resonance imaging revealed multiple hyperintense lesions in the white matter of the right hemisphere, some of which were Baló-like concentric lesions. Our diagnosis was neuromyelitis optica spectrum disorder with Baló's concentric sclerosis (BCS), although the patient was negative for anti-aquaporin-4 (anti-APQ4) antibodies. Our case suggests that Baló's concentric sclerosis overlaps with neuromyelitis optica spectrum disorder and that this overlapping is caused by a mechanism that does not involve anti-AQP4 antibodies.