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Case Reports
. 2015 Mar 17;84(11):1177-9.
doi: 10.1212/WNL.0000000000001370. Epub 2015 Feb 13.

Anti-MOG antibodies with longitudinally extensive transverse myelitis preceded by CLIPPERS

Mkael Symmonds  1 , Patrick J Waters  2 , Wilhelm Küker  2 , M Isabel Leite  2 , Ursula G Schulz  2
Affiliations
Case Reports

Anti-MOG antibodies with longitudinally extensive transverse myelitis preceded by CLIPPERS

Mkael Symmonds et al. Neurology. .
No abstract available

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Figures

Figure
Figure. Sequence of images shows clinical course
(A, B) T2-weighted MRI shows axial slices through pons. There is diffuse but patchy signal change in pons (A, dark arrow), extending into the cerebellar peduncles (B, white arrow) with some associated swelling but without substantial mass effect or hydrocephalus. (C, D) T1-weighted MRI shows curvilinear, punctate, and nodular gadolinium contrast enhancement most severe adjacent to the surface but extending into the center of the pons (C, white arrow) and cerebellar peduncles (D, white arrow). There was no restricted diffusion and no supratentorial lesions. (E) Nine weeks later, the pontine lesion no longer demonstrates contrast enhancement and there was a reduction in the extent of abnormal high T2 signal in the pons and middle cerebellar peduncles. (F) Five months after initial presentation, following steroid withdrawal, MRI spine shows a new longitudinally extensive lesion with intrinsic enhancement and edema within the conus medullaris, spanning 3 vertebral segments (T11–L1, arrows indicate top and bottom extent of lesion).
See this image and copyright information in PMC

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References

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    1. Dudesek A, Rimmele F, Tesar S, et al. CLIPPERS: chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids. Review of an increasingly recognized entity within the spectrum of inflammatory central nervous system disorders. Clin Exp Immunol 2014;175:385–396. - PMC - PubMed
    1. Simon NG, Parratt JD, Barnett MH, et al. Expanding the clinical, radiological and neuropathological phenotype of chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS). J Neurol Neurosurg Psychiatry 2012;83:15–22. - PubMed
    1. Taieb G, Duflos C, Renard D, et al. Long-term outcomes of CLIPPERS (chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids) in a consecutive series of 12 patients. Arch Neurol 2012;69:847–855. - PubMed
    1. Kitley J, Waters P, Woodhall M, et al. Neuromyelitis optica spectrum disorders with Aquaporin-4 and myelin-oligodendrocyte glycoprotein antibodies: a comparative study. JAMA Neurol 2014;71:276. - PubMed

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