B'Department of Neurology, AHEPA University Hospital, Thessaloniki, Greece.
Headache. 2011 Sep;51(8):1285-8. doi: 10.1111/j.1526-4610.2011.01884.x. Epub 2011 Mar 31.
The association of headache with transient neurological deficits and cerebrospinal fluid lymphocytosis (HaNDL) is recognized as a distinct benign, self-limited headache syndrome. Aphasic, sensory and motor disturbances predominate the clinical picture and to our knowledge, only 2 detailed cases of confusion and agitation have been previously described.
We present our recent experience with 2 cases of the HaNDL syndrome who, in addition to the focal neurological deficits, developed confusional state of variable degree, with no signs of aphasia that could jeopardize the clinical picture. An extensive laboratory and neuroimaging work-up excluded all other possible entities and both patients treated conservatively showed an excellent functional recovery.
We suggest that, although the HaNDL syndrome has a focal plateau, explaining the focal deficits; diffuse manifestations in the form of confusion may well be part of the clinical spectrum of this disorder.
头痛伴短暂性神经功能缺损和脑脊液淋巴细胞增多（HaNDL）与一种明确的良性、自限性头痛综合征相关。语言障碍、感觉和运动障碍是主要的临床表现，据我们所知，此前仅描述过 2 例详细的意识混乱和激越病例。
我们介绍了最近遇到的 2 例 HaNDL 综合征患者，除了局灶性神经功能缺损外，还出现了不同程度的意识障碍，无言语障碍迹象，这并不会影响临床特征。广泛的实验室和神经影像学检查排除了所有其他可能的疾病实体，这 2 例患者均接受了保守治疗，功能恢复良好。
我们认为，尽管 HaNDL 综合征表现为局灶性平台，解释了局灶性缺损；但以意识混乱为表现的弥漫性表现很可能是该疾病临床谱的一部分。
