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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.
Neurology India
|September 14, 2025
Summary
Supratentorial Lymphocytic Inflammation with Parenchymal Perivascular Enhancement Responsive to Steroids (SLIPPERS) is a rare neuroinflammatory condition. Early diagnosis via neuropathology is key for effective immunotherapy response.
Area of Science:
- Neurology
- Neuroimmunology
- Neuroinflammation
Background:
- Supratententorial Lymphocytic Inflammation with Parenchymal Perivascular Enhancement Responsive to Steroids (SLIPPERS) is an uncommon neuroinflammatory condition.
- Characterized by perivascular lymphocytic infiltration in the brain's supratentorial region.
Purpose of the Study:
- To describe a case of SLIPPERS syndrome.
- To highlight diagnostic challenges and treatment implications.
Main Methods:
- Case report of a 57-year-old male with rapid cognitive and behavioral decline.
- Magnetic Resonance Imaging (MRI) revealed characteristic white matter hyperintensities and contrast enhancement.
- Stereotactic brain biopsy confirmed perivascular lymphocytic inflammation.
Main Results:
- The patient presented with progressive neurological symptoms.
- Brain MRI demonstrated extensive T2/FLAIR hyperintensities and "peppering" contrast enhancement.
- Biopsy confirmed the diagnosis of SLIPPERS syndrome.
Conclusions:
- SLIPPERS syndrome is a rare condition with diverse clinical presentations.
- Neuropathological findings are essential for diagnosis.
- Prompt recognition facilitates timely immunomodulatory treatment.
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