CLIPPERS syndrome: a case report and differential diagnosis review

Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS) syndrome is a rare autoimmune disorder affecting brainstem structures and the cerebellum, first described in 2010. Its characteristic feature is a particularly good response to glucocorticoid treatment.

A 65-year-old male presented with double vision and dizziness of approximately five weeks duration prior to hospital admission. Brain magnetic resonance imaging (MRI) with gadolinium enhancement revealed a T2-weighted hyperintense, diffused lesion in the brainstem, with no evidence of restricted diffusion. The clinical presentation and the MRI features indicated CLIPPERS syndrome, which was diagnosed after excluding other causes of brainstem encephalitis.

Considering the fact that CLIPPERS syndrome is a rare and under-researched condition, it is important to include it in the differential diagnosis of numerous brainstem disorders, especially when the patient exhibits characteristic symptoms and radiological features. As CLIPPERS syndrome is a treatable disease, it cannot be neglected.