TY - JOUR
T1 - Syndrome of transient headache and neurologic deficits with cerebrospinal fluid lymphocitosis should be considered in children presenting with acute confusional state
AU - Moavero, Romina
AU - Papetti, Laura
AU - Tarantino, Samuela
AU - Battan, Barbara
AU - Salfa, Irene
AU - Deodati, Annalisa
AU - Schiaffini, Riccardo
AU - Vigevano, Federico
AU - Valeriani, Massimiliano
PY - 2018
Y1 - 2018
N2 - Background: Transient headache and neurologic deficits with cerebrospinal fluid lymphocytosis (HaNDL) is benign and self-limited, with neurologic deficits including sensory disturbance of one body side, aphasia, nausea/vomiting, weakness, decreased vision, homonymous hemianopsia, photophobia. Acute confusional state can rarely occur. Papilledema and intracranial hypertension have also been described. It is a rare entity mainly affecting adults; however, it has been sporadically described in children and adolescents. Main findings: In this clinical observational study, we describe a clinical series of three consecutive pediatric patients being diagnosed with HaNDL after presenting with altered consciousness, papilledema, and increased intracranial pressure. They all recovered without relapses. Conclusion: Presentation during childhood and adolescence is rare; the majority of pediatric cases presented with altered consciousness, which is infrequent in HaNDL. This may suggest that in childhood this symptom might be more common than in adults. All three patients presented with increased intracranial pressure and papilledema, thus suggesting that these aspects should be investigated in all patients presenting with this clinical pattern. Finally, all our patients began to suffer from migraine. This feature, together with the benign course of the disease, could favor the hypothesis of a migrainous pathophysiology of this syndrome, although this remains a speculative.
AB - Background: Transient headache and neurologic deficits with cerebrospinal fluid lymphocytosis (HaNDL) is benign and self-limited, with neurologic deficits including sensory disturbance of one body side, aphasia, nausea/vomiting, weakness, decreased vision, homonymous hemianopsia, photophobia. Acute confusional state can rarely occur. Papilledema and intracranial hypertension have also been described. It is a rare entity mainly affecting adults; however, it has been sporadically described in children and adolescents. Main findings: In this clinical observational study, we describe a clinical series of three consecutive pediatric patients being diagnosed with HaNDL after presenting with altered consciousness, papilledema, and increased intracranial pressure. They all recovered without relapses. Conclusion: Presentation during childhood and adolescence is rare; the majority of pediatric cases presented with altered consciousness, which is infrequent in HaNDL. This may suggest that in childhood this symptom might be more common than in adults. All three patients presented with increased intracranial pressure and papilledema, thus suggesting that these aspects should be investigated in all patients presenting with this clinical pattern. Finally, all our patients began to suffer from migraine. This feature, together with the benign course of the disease, could favor the hypothesis of a migrainous pathophysiology of this syndrome, although this remains a speculative.
KW - Altered conscious state
KW - Children
KW - HaNDL
KW - Intracranial hypertension
KW - Papilledema
KW - children
KW - altered conscious state
KW - intracranial hypertension
KW - papilledema
U2 - 10.1111/head.13238
DO - 10.1111/head.13238
M3 - Journal article
AN - SCOPUS:85036534673
SN - 0017-8748
VL - 58
SP - 438
EP - 442
JO - Headache
JF - Headache
IS - 3
ER -