HaNDL syndrome presenting with neuropsychological symptoms and severe papilledema: A case report

HaNDL is abbreviated from the definition of “The syndrome of transient Headache and Neurologic Deficits with cerebrospinal fluid Lymphocytosis.” The syndrome consists of symptoms and signs characterized by headache, transient neurological deficits, and lymphocytic pleocytosis in the cerebrospinal fluid (CSF). The clinical presentation may resemble some serious neurological disorders, including stroke and viral encephalitis, and may mimic a migraine attack with aura. In this article, a case of a 21-year-old female patient who presented to the emergency department with complaints of dysphasia, somnolence, and agitation following a migraine attack is presented. Grade 4 papilledema was detected on fundus examination; lymphocytic pleocytosis and protein elevation were found in the CSF examination, and the diagnosis was defined as HaNDL syndrome.