Abstract
Headache with neurological deficit and cerebrospinal fluid (CSF) lymphocytosis (HaNDL) syndrome is an important diagnosis to consider in patients presenting with the relevant features to acute medicine. Investigations should aim to exclude more serious differential diagnoses such as infectious, inflammatory and neoplastic causes prior to making a formal diagnosis of HaNDL. Increased awareness and early consideration of HaNDL would help to avoid unnecessary prolonged courses of antimicrobial therapy and invasive investigations such as cerebral angiography.
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References
- Gómez-Aranda F, Cañadillas F, Martí-Massó JF et al; Pseudomigraine with temporary neurological symptoms and lymphocytic pleocytosis. A report of 50 cases. Brain 1997; 120 (Pt 7):1105-13.
- Pascual J, Valle N; Pseudomigraine with lymphocytic pleocytosis. Curr Pain Headache Rep. 2003; 7(3):224-8.
- Cifelli A, Vaithianathar L; Syndrome of transient Headache and Neurological Deficits with cerebrospinal fluid Lymphocytosis (HaNDL). BMJ Case Rep. 2011; 29;2011
- Chapman KM, Szczygielski BI, Toth C, et al; Pseudomigraine with lymphocytic pleocytosis: a calcium channelopathy? Clinical description of 10 cases and genetic analysis of the familial hemiplegic migraine gene CACNA1A. Headache 2003; 43(8):892-5.
- Kürtüncü M, Kaya D, Zuliani L et al; CACNA1H antibodies associated with headache with neurological deficits and cerebrospinal fluid lymphocytosis (HaNDL). Cephalalgia. 2012.
- Headache Classification Subcommittee of the International Headache Society. The International Classification of Headache Disorders; 2nd Edition. Cephalalgia 2004; 24 (suppl 1): 1–160.
- Segura T, Hernandez-Fernandez F, Sanchez-Ayaso P et al; Usefulness of multimodal MR imaging in the differential diagnosis of HaNDL and acute ischemic stroke. BMC Neurol. 2010; 10:120.
