A middle aged male with a rare cause of ataxia—A case report

Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS) is a rare and newly recognized long-standing inflammatory central nervous system (CNS) condition which primarily affects the pons, with characteristic clinical as well as radiological features. The aim of this work was to familiarize the radiologists with this rare but important neuroinflammatory condition.

We presented a report on a 33-year aged male who presented with gait imbalance, right-sided weakness, facial numbness, and dysarthria. Magnetic resonance imaging (MRI) revealed ill-defined hyperintensities in the pons, extending to the midbrain and cerebellum, with characteristic punctuate gadolinium enhancement. The patient received intravenous steroids for treatment, after which he began oral corticosteroids, leading to substantial recovery.

This case highlights the significance of identifying the distinct radiological characteristics of CLIPPERS, given its challenging diagnosis and the critical role of corticosteroid therapy in managing this condition. Despite advances in diagnostic criteria, neuropathological confirmation remains essential due to the condition's polymorphic presentation.