HaNDL syndrome: transient headache and neurological deficits with cerebrospinal fluid lymphocytosis.
We report the case of a 54-year-old woman with multiple presentations to the emergency department with severe headache, transient variable neurological deficits and normal investigations aside from CSF lymphocytosis. This represents a rare but under-diagnosed condition, transient headache and neurological deficits with cerebrospinal fluid lymphocytosis (HaNDL) syndrome. HaNDL is an important differential diagnosis for headache. We summarise the current knowledge about its clinical course, diagnosis and typical investigation findings.
Department of General Medicine, North Shore Hospital, Auckland.
Joseph
J
Hutton
Department of General Medicine, North Shore Hospital, Auckland.
Daniel
D
Wellington
Diabetes Centre, North Shore Hospital, Auckland.
Steven
S
Miller
D002555:Cerebrospinal Fluid / Q000166:cytology; D003937:Diagnosis, Differential; D005260:Female; D006261:Headache / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D008218:Lymphocytosis / Q000134:cerebrospinal fluid / Q000150:complications* / Q000175:diagnosis; D008875:Middle Aged; D009422:Nervous System Diseases / Q000150:complications / Q000175:diagnosis*; D013577:Syndrome; D014057:Tomography, X-Ray Computed