title: CLIPPERS and the need for long-term immunosuppression.
abstract: Chronic Lymphocytic Inflammation with Pontine Perivascular Enhancement Responsive to Steroids (CLIPPERS) is a rare chronic inflammatory disorder of the central nervous system. Herein, we describe the case of a 62-year-old female who presented with right sided facial tingling, gait ataxia and diplopia. Neuroimaging revealed pontine curvilinear enhancing lesions with extension into cerebellar peduncles, characteristic of CLIPPERS. This report discusses the differential diagnosis and the importance of prolonged immunomodulatory treatment for this rare neuro-inflammatory disorder. Long-term immunosuppression appears to be mandatory in order to achieve sustained remission and prevent disability related to atrophy of the structures involved in repeated attacks.
authors.affiliation: 1 Neurology registrar, Department of Neurology, University Hospital Galway, Galway, Ireland.
authors.forename: Tarig M
authors.initials: TM
authors.lastname: Abkur
authors.affiliation: 1 Neurology registrar, Department of Neurology, University Hospital Galway, Galway, Ireland.
authors.forename: Hugh
authors.initials: H
authors.lastname: Kearney
authors.affiliation: 2 Consultant Neurologist, Department of Neurology, University Hospital Galway, Galway, Ireland.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Hennessy
mesh_terms: D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D002493:Central Nervous System Diseases / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology / Q000503:physiopathology; D004172:Diplopia / Q000000981:diagnostic imaging* / Q000209:etiology; D005260:Female; D020234:Gait Ataxia / Q000000981:diagnostic imaging* / Q000209:etiology; D006801:Humans; D007165:Immunosuppression Therapy; D007249:Inflammation / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology / Q000503:physiopathology; D008279:Magnetic Resonance Imaging; D008775:Methylprednisolone / Q000627:therapeutic use; D008875:Middle Aged; D059906:Neuroimaging; D011149:Pons / Q000473:pathology*; D013129:Spinal Puncture; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D000893:Anti-Inflammatory Agents; D008775:Methylprednisolone
keywords: Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids; brain stem; neuro-inflammation