Atypical multiple sclerosis with concentric or lamellar demyelinated lesions: two Japanese patients studied post mortem.

In two Japanese patients with atypical multiple sclerosis studied post mortem, there was a concentric or lamellar pattern of demyelinated lesions. This was detected in the thoracic spinal cord of one patient and in the optic chiasm of the other. In addition, lesions more typical of multiple sclerosis were present. Clinically, both cases ran courses intermediate between Baló's disease and multiple sclerosis. The patients had a relatively rapid progression of disease and had severe visual disability or paraplegia associated with fever, headache, and pleocytosis. The formation of a concentric or lamellar pattern of the lesions in cases of demyelinating diseases may relate to the brief duration or to the acuteness or severity of the disease process.