CLIPPERS and the need for long-term immunosuppression.

Area of Science:

• Neurology
• Neuroimmunology
• Radiology

Background:

• Chronic Lymphocytic Inflammation with Pontine Perivascular Enhancement Responsive to Steroids (CLIPPERS) is a rare chronic inflammatory central nervous system disorder.
• CLIPPERS primarily affects the brainstem and cerebellum, presenting unique diagnostic challenges.

Observation:

• A 62-year-old female presented with facial tingling, gait ataxia, and diplopia.
• Neuroimaging demonstrated characteristic pontine curvilinear enhancing lesions extending into the cerebellar peduncles.

Findings:

• The case highlights the typical imaging findings of CLIPPERS.
• Differential diagnosis for pontine lesions was considered.

Implications:

• Prolonged immunomodulatory treatment is essential for sustained remission in CLIPPERS.
• Long-term immunosuppression may prevent disability caused by atrophy from recurrent inflammatory attacks.