Symptomatic intracranial hypertension during recovery from the syndrome of headache with neurologic deficits and cerebrospinal fluid lymphocytosis (HANDL).
The syndrome of headache with neurologic deficits and cerebrospinal fluid lymphocytosis (HANDL) is rare; it comprises migrainous headaches (generally in headache-naïve people), fluctuating neurological symptoms and cerebrospinal fluid (CSF) lymphocytosis. The syndrome generally runs a benign, self-limiting course over weeks. A small proportion of patients develop intracranial hypertension as a consequence of the illness. Recurrence of headaches or development of visual symptoms following apparent recovery from HANDL should prompt urgent re-evaluation for elevated intracranial pressure. Short-to-medium term management with CSF drainage and acetazolamide may be necessary to prevent visual loss.
Department of Neurology, Auckland Hospital, Auckland, New Zealand EoinM@adhb.govt.nz.
Eoin
E
Mulroy
Department of Ophthalmology, Auckland Hospital, Auckland, New Zealand.
Joel
J
Yap
Department of Ophthalmology, Auckland Hospital, Auckland, New Zealand.
Helen
H
Danesh-Meyer
Department of Neurology, Auckland Hospital, Auckland, New Zealand.
Neil
N
Anderson
D000293:Adolescent; D000328:Adult; D005260:Female; D006261:Headache / Q000150:complications*; D006801:Humans; D019586:Intracranial Hypertension / Q000209:etiology*; D008218:Lymphocytosis / Q000134:cerebrospinal fluid* / Q000150:complications; D008297:Male; D009422:Nervous System Diseases / Q000150:complications*
HEADACHE; MIGRAINE; VISION