Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS)
Diagnosis probable
Presentation
Dizziness
Patient Data
Age: 45 years
Gender: Male
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Edema and enlargement noted in the pons extending to the bilateral branchium pontis, right greater than left.
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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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