Filina Tatiana, Feja Kristina N, Tolan Robert W
The Children's Hospital at Saint Peter's University Hospital, New Brunswick, NJ 08901, USA.
Clin Pediatr (Phila). 2013 Jun;52(6):496-502. doi: 10.1177/0009922813483358. Epub 2013 Apr 3.
We report a 16-year-old adolescent with 2 episodes of focal neurological deficits, pseudomigrainous headache, and lymphocytic pleocytosis due to the syndrome of transient headache and neurological deficits with cerebrospinal fluid (CSF) lymphocytosis (HaNDL), also known as pseudomigraine with CSF pleocytosis. Review of the literature identifies 13 additional cases of HaNDL in the pediatric population. These cases are reviewed and evidence for possible etiopathogenesis is discussed. This syndrome may mimic much more common conditions such as complicated or hemiplegic migraine, aseptic meningitis, meningoencephalitis, or stroke. However, HaNDL differs from complicated or hemiplegic migraine and stroke since CSF pleocytosis is uniformly present. There are many infectious conditions that can present with neurological deficits, headache, and CSF pleocytosis, but the transient nature of the deficits and lack of a consistently identifiable infectious etiology despite extensive evaluations typify HaNDL. This clinical syndrome is underrecognized and underreported. HaNDL remains a diagnosis of exclusion.
我们报告了一名16岁青少年，因短暂性头痛伴脑脊液淋巴细胞增多的神经系统缺损综合征（HaNDL），又称伴脑脊液淋巴细胞增多的偏头痛样头痛，出现了2次局灶性神经功能缺损、偏头痛样头痛和淋巴细胞性脑脊液细胞增多。文献回顾发现儿科人群中还有13例HaNDL病例。对这些病例进行了回顾，并讨论了可能的病因发病机制证据。该综合征可能会模仿更常见的疾病，如复杂性或偏瘫性偏头痛、无菌性脑膜炎、脑膜脑炎或中风。然而，HaNDL与复杂性或偏瘫性偏头痛及中风不同，因为脑脊液淋巴细胞增多始终存在。有许多感染性疾病可表现为神经功能缺损、头痛和脑脊液淋巴细胞增多，但缺损的短暂性以及尽管进行了广泛评估仍缺乏始终可识别的感染病因是HaNDL的典型特征。这种临床综合征未得到充分认识和报道。HaNDL仍然是一种排除性诊断。
