Sunday, March 28, 2010

CLIPPERS syndrome

Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids.  Clippers.  (Mayo Clinic) AAN 2010 P02:182.  Eight patients had a distinctive clinical and radiological CNS disease with treatment.  Presentation was episodic diplopia or facial paresthesias with subsequent progressive ataxia, diplopia, dysarthria and paresis responsive to high dose steroids.  MRi showed gado enhanced peppering of pons extending into the medulla.  Weaning steroids always led to worsening.  Neuropath showed perivascular T lymphocytic infiltration without evidence of granulomas, lymphoma or vasculitis. 

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