Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS)

Case contributed by Dr Seth An

Presentation

Dizziness

Patient Data

Age: 45 years
Gender: Male

Edema and enlargement noted in the pons extending to the bilateral branchium pontis, right greater than left.

T2 weighted images confirm the findings appreciated on CT with T2 prolongation in similar areas. There are multiple punctate areas of enhancement within the pons. Punctate areas of enhancement also seen on the axial images extending to the left cerebellar peduncle.

Case Discussion

The pontine and peduncle lesions were stable for 1 year and CSF studies were nondiagnostic. Over the next year, patient developed dysarthria, diplopia and pericarditis of uncertain etiology. The patient was started on steroids which improved the patient's symtpoms.  Therefore, the presumed diagnosis of CLIPPERS was made.

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Case Information

rID: 27740
Case created: 17th Feb 2014
Last edited: 25th Jan 2016
Inclusion in quiz mode: Included

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