A 55-year-old woman presented with rapid hemiparesis with MRI showing alternating concentric rings. On examination, there was dysarthria and brisk

Question

A 55-year-old woman presented with rapid hemiparesis with MRI showing alternating concentric rings. On examination, there was dysarthria and brisk reflexes. Initial investigations showed: MRI diffusion and enhancement formed lamellated rings within a white-matter lesion. What is the most appropriate management?

Accepted Answer

Treat as a disabling demyelinating relapse with high-dose methylprednisolone after excluding infection

Answer

Withhold treatment because Baló concentric sclerosis never produces functionally disabling relapses

Answer

Start antituberculous therapy because all ring-enhancing lesions represent central nervous system tuberculosis

Answer

Begin levodopa because brisk reflexes and dysarthria indicate a hypokinetic movement disorder

Answer

Treat empirically for a pyogenic abscess because concentric rings are typical of bacterial infection

Balo concentric sclerosis — SCE Neurology MCQ