Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids

Case contributed by Dr Jennie Roberts

Presentation

Bilateral L>R facial numbness. Jaw jerk brisk ? demyelination ? trigeminal neuropathy

Patient Data

Age: 60
Gender: Male

Multiple small foci of T2/FLAIR hyperintensity and contrast enhancement in the pons and less so in the medulla and cerebellum where they are located at the grey-white junction. 

Case Discussion

Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS) is characterised by infiltration of the brain by inflammatory cells particularly the pons, with punctate foci of contrast enhancement best seen on MRI. The disorder usually readily responds to immunosuppression with glucocorticosteroids.

This case was confirmed histologically with brain biopsy.

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Case information

rID: 37520
Case created: 11th Jun 2015
Last edited: 4th Sep 2016
Inclusion in quiz mode: Included

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