title: Recurrent headache in a five year old boy.
abstract: Headache is infrequent in early childhood. Headache and neurological deficits associated with cerebrospinal fluid (CSF) lymphocytosis (HaNDL), a variant of migraine, is a rare disorder. A 5-year-old boy presented with recurrent episodes of headache for 6 months. Each episode lasted for a week and in the current episode, he was symptomatic for 3 days. All the episodes were associated with paresthesias and CSF lymplocytosis with normal protein and sugar. There was history of migraine in his family. His magnetic resonance imaging (MRI) brain with contrast with magnetic resonance (MR) angiography and venography were normal. Work-up for relevant causes of infection and vasculitis were negative. His symptoms subsided on oral antimigraine prophylaxis and he has been on remission for last 8 months. HaNDL should be considered in relevant clinical scenarios, as it prevents unnecessary investigations, therapy, and hospitalization.
authors.affiliation: Department of Pediatrics, Child Neurology Division, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Lokesh
authors.initials: L
authors.lastname: Saini
authors.affiliation: Department of Pediatrics, Child Neurology Division, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Ranjith M
authors.initials: RM
authors.lastname: Kumar
authors.affiliation: Department of Pediatrics, Child Neurology Division, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Biswaroop
authors.initials: B
authors.lastname: Chakrabarty
authors.affiliation: Department of Pediatrics, Child Neurology Division, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Sheffali
authors.initials: S
authors.lastname: Gulati
keywords: CSF lymphocytosis; HaNDL; headache; migraine; toddler