scholarly journals Syndrome of transient headache and neurologic deficits with cerebrospinal fluid lymphocytosis (HaNDL)

2018 ◽  
pp. 68-71
Author(s):  
Laryssa Crystinne Azevedo Almeida ◽  
Marcelo Moraes Valença
Keyword(s):  
Cerebrospinal Fluid ◽  
Emergency Room ◽  
Clinical Picture ◽  
Narrative Review ◽  
Neurological Deficits ◽  
Headache Syndrome ◽  
Neurologic Deficits

The authors make a narrative review on "headache syndrome and transient neurological deficits with cerebrospinal fluid lymphocytosis (CRL)," a rare, underdiagnosed disorder of little knowledge by physicians specializing in care in the emergency room. Aspects of the clinical picture, diagnosis, prognosis, and treatment are discussed  

La sindrome “Cefalea e deficit neurologici transitori con linfocitosi liquorale”: un’altra encefalopatia autoimmune?

2021 ◽  
Vol 24 (8) ◽  
pp. 241
Author(s):  
Maria Elisa Morelli ◽  
Marco Carrozzi
Keyword(s):  
Cerebrospinal Fluid ◽  
Migraine Headache ◽  
Neurological Deficits ◽  
Age Group ◽  
Impaired Consciousness ◽  
Neurologic Deficits ◽  
Paediatric Age ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
Autoimmune Pathogenesis

Headache and neurologic deficits with cerebrospinal fluid lymphocytosis syndrome (HaNDL) is a rare nosographic entity, which mainly affects adults but can also occur in the paediatric age. In the literature, 31 cases in this age group are described. Symptomatology typically lasts about three months with episodes that tend to relapse. An autoimmune pathogenesis has been hypothesized. The paper describes the case of an adolescent who presented with three acute and transient episodes of migraine headache in three days associated with impaired consciousness, focal neurological deficits and CSF lymphocytosis. After treatment with steroidal and non-steroidal anti-inflammatory drugs, the patient did not relapse in the following four months. The treatment indicated in the literature is only supportive (analgesics, antiemetics), however in this case the anti-inflammatory therapy reduced the duration of the episode and the recurrence of further episodes.

scholarly journals Borrelia lusitaniae Infection Mimicking Headache, Neurologic Deficits, and Cerebrospinal Fluid Lymphocytosis

2019 ◽  
Vol 34 (12) ◽  
pp. 748-750
Author(s):  
José Pedro Vieira ◽  
Maria João Brito ◽  
Isabel Lopes de Carvalho
Keyword(s):  
Polymerase Chain Reaction ◽  
Cerebrospinal Fluid ◽  
International Headache Society ◽  
Clinical History ◽  
Chain Reaction ◽  
Headache Syndrome ◽  
Neurologic Deficits ◽  
Borrelia Lusitaniae ◽  
Polymerase Chain

Headache with neurologic deficits and cerebrospinal fluid lymphocytosis (HaNDL) is a rare headache syndrome included in the Classification of Headache of the International Headache Society as a “headache attributed to non-infectious inflammatory intracranial disease.” We report one 15-year-old patient with clinical history and cerebrospinal fluid findings compatible with the diagnosis of HaNDL in whom Borrelia lusitaniae was identified in cerebrospinal fluid by polymerase chain reaction.

scholarly journals Rare mimicker of transient ischaemic attacks: the syndrome of transient headache and neurological deficits with cerebrospinal luid lymphocytosis

2019 ◽  
Vol 7 (6) ◽  
pp. 2442
Author(s):  
Philo Hazeena ◽  
Naga Karthik Vanukuri ◽  
Shankar V.
Keyword(s):  
Cerebrospinal Fluid ◽  
Clinical History ◽  
Severe Headache ◽  
Neurological Deficits ◽  
Serial Imaging ◽  
Transient Ischaemic Attacks ◽  
Neurologic Deficits ◽  
High Degree ◽  
The Brain

The syndrome of transient headache and neurologic deficits associated with cerebrospinal fluid lymphocytosis (HaNDL) is a benign and self limiting disorder characterized by 1 or more episodes of severe headache and transient neurologic deficits with lymphocytic pleocytosis in the cerebrospinal fluid. We report a case of a 30-year-old male who presented with four episodes of headache followed by hemi paresis and hemisensory loss in a week the patient was completely asymptomatic in between each episode of headache with neurological deficits. Persistent serial imaging to visualize the brain were normal with evidence of cerebrospinal fluid lymphocytosis, which lead to the diagnosis of HaNDL. We need to advocate a high degree of suspicion for HaNDL in the background of strong clinical history and findings, when imaging is normal.

Anti-NMDAR encephalitis mimicking HaNDL syndrome

Cephalalgia ◽  
2014 ◽  
Vol 34 (12) ◽  
pp. 1012-1014 ◽  
Author(s):  
Carsten Finke ◽  
Annerose Mengel ◽  
Harald Prüss ◽  
Winfried Stöcker ◽  
Andreas Meisel ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Nmda Receptor ◽  
Diagnostic Criteria ◽  
Clinical Picture ◽  
Clinical Phenotype ◽  
Neurological Deficits ◽  
Igg Antibodies ◽  
Nmda Receptor Encephalitis ◽  
Csf Analysis ◽  
Nmdar Encephalitis

Background Anti-NMDA receptor encephalitis typically manifests as severe multistage neuropsychiatric syndrome. However, milder or incomplete forms of the disorder have been recognised. Here, we report on a patient with anti-NMDA receptor encephalitis with a clinical phenotype mimicking the syndrome of headache with neurological deficits and cerebrospinal fluid (CSF) lymphocytosis (HaNDL). Case A 67-year-old man presented with recurrent stereotyped episodes of hemianopia, aphasia and right hemiparesis accompanied by throbbing headaches as well as confusion and agitation. CSF analysis showed lymphocytic pleocytosis. Additional analysis revealed NMDA receptor IgG antibodies in the patient’s CSF. Following immunotherapy, no further episodes occurred and NMDAR antibodies became undetectable. No NMDAR or other neuronal antibodies were detected in archived serum and CSF samples of 12 HaNDL patients fulfilling the current diagnostic criteria. Conclusions While anti-NMDAR encephalitis can manifest with a HaNDL-like clinical picture, HaNDL syndrome itself does not appear to be mediated by anti-NMDAR antibodies.

scholarly journals Cerebrospinal fluid biomarkers and apolipoprotein E genotype in cerebral amyloid angiopathy. A narrative review

2021 ◽  
Vol 2 ◽  
pp. 100010
Author(s):  
Aikaterini Theodorou ◽  
Ioanna Tsantzali ◽  
Elisabeth Kapaki ◽  
Vasilios C. Constantinides ◽  
Konstantinos Voumvourakis ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Apolipoprotein E ◽  
Cerebral Amyloid Angiopathy ◽  
Narrative Review ◽  
Amyloid Angiopathy ◽  
Cerebrospinal Fluid Biomarkers ◽  
Cerebral Amyloid ◽  
Apolipoprotein E Genotype

HaNDL Syndrome: Case Report and Literature Review

2018 ◽  
Vol 34 (3) ◽  
pp. 161-167 ◽  
Author(s):  
Amy Armstrong-Javors ◽  
Kalpathy Krishnamoorthy
Keyword(s):  
Cerebrospinal Fluid ◽  
Literature Review ◽  
Severe Headache ◽  
Resonance Imaging ◽  
Neurologic Deficits ◽  
Elevated Protein ◽  
Episodic Nature ◽  
Magnetic Resonance Imaging Mri ◽  
Fundoscopic Examination ◽  
Pathophysiologic Mechanisms

Headache and Neurologic Deficits with cerebrospinal fluid Lymphocytosis (HaNDL) syndrome is a rare stroke mimicker characterized by moderate to severe headache temporally associated with transient neurologic deficits, typically hemiparesis, hemisensory disturbance, and/or aphasia. Cerebrospinal fluid studies reveal a lymphocytosis and elevated protein. Episodes recur over a period no longer than 3 months. Here we describe the case of a 16-year-old boy who presented with 3 episodes of self-resolving neurologic deficits, papilledema on fundoscopic examination, and leptomeningeal enhancement on magnetic resonance imaging (MRI). We additionally review the 30 previously reported pediatric cases of HaNDL syndrome, with a focus on possible etiologic and pathophysiologic mechanisms of disease. The reported case and literature review highlight the benign episodic nature of this likely underrecognized syndrome as well as the higher than expected frequency of abnormal neuroimaging findings.

scholarly journals CLINICAL-EPIDEMIOLOGICAL CHARACTERISTICS OF ASEPTIC MENINGITIS IN CHILDREN OF KHMELNITSKYI REGION (PODILSKYI REGION, UKRAINE): FOURTEEN-YEAR EPIDEMIOLOGICAL OBSERVATION

2019 ◽  
Vol 11 (1) ◽  
pp. 41-45
Author(s):  
L. V. Pypa ◽  
R. V. Svistilnik ◽  
Yu. N. Lysytsia ◽  
K. Yu. Romanchuk ◽  
I. V. Odarchuk
Keyword(s):  
Central Nervous System ◽  
Cerebrospinal Fluid ◽  
Nervous System ◽  
Aseptic Meningitis ◽  
Clinical Picture ◽  
Epileptic Seizures ◽  
Complete Recovery ◽  
The Central Nervous System ◽  
Meningitis In Children ◽  
Epidemiological Characteristics

Aim of work – to analyze the etiological structure, epidemiological structure, social-demographic features and the nature of the development of complications of the central nervous system in aseptic meningitis in children in Khmelnitskyi region for the period 2004-2017.Materials and methods. It was conducted a prospective analysis of 208 cases of aseptic meningitis in children of whom 138 people were boys and 70 people were girls. The etiology of the disease was determined by studying cerebrospinal fluid using PCR method. Complications of the central nervous system were diagnosed on the basis of the clinical picture and CT or MRI scans. The analytical method was used to conduct the analysis of the received data.Results. The highest seasonal increase of the incidence was from August to October and it was 65.6% with its peak in September (24.0%). The clinical picture was characterized by a moderate trend in 71.2% of cases and in 28.8% by a severe course. In 100% of cases the disease began with a fever, headache (83.6%), vomiting (76.9%), abdominal pain with diarrhea (6.2%), epileptic seizures (0.9%). The average level of cytosis was 269.4±196.7 cells/mm3with a predominance of lymphocytes and the average protein level in cerebrospinal fluid was 73 ± 36 mg/dl. The etiological factor was established in 18 (8.6%) patients.Conclusions. Enterovirus remains to be the main pathogen which was determined in 72.2% of cases. The second place was taken by herpes viruses (22.2% of cases), the third place was given to the mumps virus (5.6% of cases) (in etiologically verified cases). In most cases the disease ended in complete recovery but in 47 (22.6%) patients the complications were observed. The prevalence of aseptic meningitis among children in Khmelnitskyi region was 6.2 per 100,000 children, and males outnumbered females by a 2:1 ratio.

scholarly journals A Case of HaNDL with Low Cerebrospinal Fluid Level of Neurofilament Light Chain

2020 ◽  
Vol 12 (3) ◽  
pp. 334-338
Author(s):  
Aysel Büsra Sisman ◽  
Muhammet Duran Bayar ◽  
Sema İçöz ◽  
Vuslat Yilmaz ◽  
Murat Kürtüncü ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Light Chain ◽  
Primary Headache ◽  
Neurological Deficits ◽  
Neurofilament Light Chain ◽  
Neurofilament Light ◽  
Cerebrospinal Fluid Level ◽  
Csf Levels ◽  
Characteristic Features ◽  
Headache Patients

Diagnosis of the syndrome of headache and neurological deficits with cerebrospinal fluid (CSF) lymphocytosis (HaNDL) is based on clinical features, and no diagnostic biomarkers are available. We present a case presenting with characteristic features of HaNDL and an MRI lesion in the splenium of corpus callosum. CSF neurofilament light chain (NFL) levels were assessed in this patient together with 7 additional HaNDL patients, 18 multiple sclerosis (MS) patients, and 15 primary headache patients. Both HaNDL and primary headache patients showed significantly lower NFL levels than MS patients. Our results suggest that increased CSF levels of NFL and neuroaxonal loss are not characteristic features of HaNDL. Neurological disorders mimicking HaNDL often present with increased levels of NFL, and thus CSF measurement of NFL might be useful in differential diagnosis of HaNDL.

scholarly journals Lymphatic outflow of cerebrospinal fluid is reduced in glioma

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Qiaoli Ma ◽  
Felix Schlegel ◽  
Samia B. Bachmann ◽  
Hannah Schneider ◽  
Yann Decker ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Blood Circulation ◽  
Near Infrared ◽  
Cranial Nerves ◽  
Neurological Deficits ◽  
Cisterna Magna ◽  
Nir Imaging ◽  
Magnetic Resonance Imaging Mri ◽  
Csf Turnover

Abstract Glioblastoma is a malignant brain tumor with mean overall survival of less than 15 months. Blood vessel leakage and peritumoral edema lead to increased intracranial pressure and augment neurological deficits which profoundly decrease the quality of life of glioblastoma patients. It is unknown how the dynamics of cerebrospinal fluid (CSF) turnover are affected during this process. By monitoring the transport of CSF tracers to the systemic blood circulation after infusion into the cisterna magna, we demonstrate that the outflow of CSF is dramatically reduced in glioma-bearing mice. Using a combination of magnetic resonance imaging (MRI) and near-infrared (NIR) imaging, we found that the circulation of CSF tracers was hindered after cisterna magna injection with reduced signals along the exiting cranial nerves and downstream lymph nodes, which represent the major CSF outflow route in mice. Due to blockage of the normal routes of CSF bulk flow within and from the cranial cavity, CSF tracers were redirected into the spinal space. In some mice, impaired CSF clearance from the cranium was compensated by a lymphatic outflow from the sacral spine.

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