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Expanding the Clinical, Radiological, and Pathological Spectrum of SLIPPERS-A Rare Steroid-Responsive
M K Farsana1, B N Nandeesh2, Jitender Saini3
1Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India.
Background:
The term Supratentorial Lymphocytic Inflammation with Parenchymal Perivascular Enhancement Responsive to Steroids ("SLIPPERS") is an uncommon form of neuroinflammation.
Case:
We report a 57-year-old gentleman with rapidly progressive cognitive and behavioral changes. Magnetic resonance imaging (MRI) brain showed confluent T2/fluid-attenuated inversion recovery (FLAIR) hyperintensities involving white matter of bilateral frontal, anterior temporal lobes, external capsule, right thalamus, and right corona radiata with peppering contrast enhancement. Stereotactic brain biopsy showed prominent perivascular lymphocytic inflammation. The patient responded well to immunotherapy.
Conclusions:
SLIPPERS syndrome is an exceedingly rare entity with varied clinical presentation, and diagnosis is dependent on neuropathological features. Prompt recognition is crucial for a timely response to immunomodulation.
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