A Case Report: The CSF Characteristics of HaNDL Syndrome

Document Type

Article

Publication Date

1-1-2020

Abstract

Background: Headache and Neurologic Deficits with cerebrospinal fluid Lymphocytosis (HaNDL) is a rare and underdiagnosed syndrome that mimics recurrent stroke, migraine with aura, and encephalitis. Objective: Describe the presentation, clinical characteristics, and cerebrospinal fluid (CSF) findings in a patient with HaNDL and provide insight into the importance of the recognition of this syndrome. Methods: The authors describe a unique case of (HaNDL) during which the patient underwent three lumbar punctures over 26 days. Results: The authors demonstrate the natural course of CSF characteristics of a patient with HaNDL, with rising and falling lymphocyte counts. Additionally, the authors provide an example of the clinical presentation of HaNDL, with episodic attacks over the course of 1 month of migraine headache, hemibody paresthesias, hemibody weakness, and encephalopathy. Conclusions: HaNDL is a headache syndrome mimicking viral encephalitis, migraine with aura, and recurrent cerebral ischemic events. While HaNDL is a diagnosis of exclusion, the syndrome's association with characteristic clinical and laboratory findings are important to recognize. Furthermore, a monophasic pattern of CSF lymphocytosis in HaNDL may be observed. Implications for Nursing: Increased recognition of this syndrome may help prevent unnecessary tests and treatments when patients present with recurrent episodes.

Publication Title

Journal of Doctoral Nursing Practice

Volume

13

Issue

2

First Page

103

Last Page

107

Digital Object Identifier (DOI)

10.1891/JDNP-D-19-00045

PubMed ID

32817498

ISSN

23809418

E-ISSN

23809426

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