title: Confusional state in the syndrome of HaNDL.
abstract: BACKGROUND
  The association of headache with transient neurological deficits and cerebrospinal fluid lymphocytosis (HaNDL) is recognized as a distinct benign, self-limited headache syndrome. Aphasic, sensory and motor disturbances predominate the clinical picture and to our knowledge, only 2 detailed cases of confusion and agitation have been previously described.
  
  
  METHODS
  We present our recent experience with 2 cases of the HaNDL syndrome who, in addition to the focal neurological deficits, developed confusional state of variable degree, with no signs of aphasia that could jeopardize the clinical picture. An extensive laboratory and neuroimaging work-up excluded all other possible entities and both patients treated conservatively showed an excellent functional recovery.
  
  
  CONCLUSIONS
  We suggest that, although the HaNDL syndrome has a focal plateau, explaining the focal deficits; diffuse manifestations in the form of confusion may well be part of the clinical spectrum of this disorder.
authors: B'Department of Neurology, AHEPA University Hospital, Thessaloniki, Greece.
authors: Dimitris
authors: D
authors: Parissis
authors: Panagiotis
authors: P
authors: Ioannidis
authors: George
authors: G
authors: Balamoutsos
authors: Dimitris
authors: D
authors: Karacostas
mesh_terms: D000208:Acute Disease; D000328:Adult; D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology; D002555:Cerebrospinal Fluid; D003221:Confusion / Q000150:complications*; D006261:Headache / Q000150:complications*; D006801:Humans; D007964:Leukocytosis / Q000150:complications*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000150:complications*; D014057:Tomography, X-Ray Computed