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Hemidysgeusia, phantosmia and respiratory arrest: a case of CLIPPERS
  1. Peter Baoviet Nguyen1,
  2. David Prentice2,
  3. Robert Brazel3 and
  4. Wai Kuen Leong1
  1. 1 Department of Neurology, Royal Perth Hospital, Perth, Western Australia, Australia
  2. 2 Perron Institute, Queen Elizabeth II Medical Centre, Nedlands, Western Australia, Australia
  3. 3 Neurological Intervention and Imaging Service of Western Australia, Queen Elizabeth II Medical Centre, Nedlands, Western Australia, Australia
  1. Correspondence to Dr Peter Baoviet Nguyen, peterbaovietnguyen{at}


A 56-year-old man presented with a relapse of likely chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS) after a reduction of steroid dose. MRI demonstrated new perivascular FLuid-Attenuated Inversion Recovery (FLAIR) signal hyperintensity involving the dorsal pontomedullary junction and progressing inferiorly into the dorsal medulla oblongata. His admission to hospital was complicated by a respiratory arrest.

  • brain stem/cerebellum
  • mechanical ventilation
  • sleep disorders (respiratory medicine)
  • immunology

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  • Contributors PBN drafted the case report and performed the literature review. WKL revised the manuscript critically and provided corrections and additional information to the case presentation. DP revised the manuscript critically and provided key guidance for the discussion. RB provided the included MRI and annotated the figures to demonstrate important pathophysiological findings.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Obtained.