What is Clippers Disease?

(Chronic Lymphocytic Inflammation with Pontocerebellar Perivascular Enhancement Responsive to Steroids)

C.L.I.P.P.E.R.S. is a very rare inflammatory disease of the central nervous system. It is mainly classed as a brain disorder that causes lesions on the brain. On occasion though, it can also cause lesions on the spine.

Patients ranging from the age of 14-86 have been diagnosed with CLIPPERS and it is very difficult to diagnose, often as a last resort when lots of other conditions have been ruled out that can present similar symptoms. For example, my daughter was initially diagnosed with A.D.E.M. (Acute Disseminated Encephalomyelitis). A lot of medical staff aren’t familiar with CLIIPPERS because of its rarity.

Symptoms can vary depending on where exactly, the number of and how large the lesions are.

Common symptoms:

  • Diplopia (double vision)
  • Subacute gait ataxia (loss of coordination)
  • Dysarthria (difficulty speaking)
  • Dizziness
  • Nausea
  • Dysgeusia (distortion of taste)
  • Pseudobulbar affect (pathological crying or laughter)
  • Tinnitus
  • Tremor
  • Nystagmus (involuntary eye movement)
  • Paraparesis (muscle weakness)
  • sensory loss
  • Spasticity

Diagnosis

Diagnosis is very difficult. In some cases CLIPPERS is confirmed via a biopsy of one of the lesions. In other cases, it is diagnosed without invasive surgery, from other symptoms including the characteristics on MRI scans.

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Treatment

Treatment often starts with patients being treated with glucocorticosteroids intravenously for 3-5 days followed by an often lengthy course of corticosteroids such as prednisone in tablet form. The dosage is often gradually tapered down.

Once the treatment is halted symptoms can often re-occur. Patients are often treated with immunosuppression medication to delay or prevent relapse.