Syndrome of transient headache and neurological deficits with cerebrospinal fluid lymphocytosis (HaNDL)

Abstract

| http://medcraveonline.com minutes later, and after another 15 minutes the patient experienced an intense pulsating headache in the right temporal region scoring 8 on the Visual Analogue Scale (VAS) and accompanied by vomiting, photo-, phono-, and osmophobia. The pain persisted for 6-8 hours, and afterwards the patient fell asleep. The patient experienced three more similar episodes with an interval of 2 to 3 days. Two days after the last episode, the patient again woke up with an intense headache, feeling discomfort in an arm and the face. The headache score reached 10 on the VAS. Due to these complaints, the patient was admitted to a hospital. On admission: no abnormalities in the general clinical or neurological status. Body temperature on admission: 37.0°C. A complete blood count revealed a moderate leukocytosis-13.3•109/L (reference interval: 4.0-9.0•109/L), but a follow-up test performed the next day was normal (white blood cell count: 6.8·109/L). Serological tests for HIV infection, hepatitis B and C, as well as syphilis, were negative. A cerebrospinal fluid examination revealed a lymphocytic pleocytosis (86cells/mm 3) and an insignificant increase in protein content (to 66mg/dL), in the absence of other abnormalities.

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“…This syndrome was first described by Bartleson JD et al 1 and the term HaNDL was proposed in 1995 by Berg MJ et al 2 Approximately 100 cases of HaNDL syndrome have been described in the literature, but it is assumed that the prevalence of this type of headache is higher, approximately 0.2 case per 100,000 population. [3][4][5][6] Most cases have been reported by Gómez-Aranda et al 7 who described 50 patients with HaNDL syndrome. 7 Below we present our own case report of a female patient with HaNDL syndrome.…”