Case Report

Volume: 5 | Issue: 5 | Published: May 20, 2021 | Pages: 133 - 137 | DOI: 10.24911/ejmcr/173-1588758405

Headache, confusion, and behavioral changes - a HaNDL case report


Authors: Annaliese Stolz , Rachel Efendy , Yogesh Apte


Article Info

Authors

Annaliese Stolz

Intensive Care Unit, Caboolture Hospital, McKeen St, Caboolture 4510 Australia

Rachel Efendy

Intensive Care Unit, Caboolture Hospital, McKeen St, Caboolture 4510 Australia

Yogesh Apte

Intensive Care Unit, Caboolture Hospital, McKeen St, Caboolture 4510 Australia.

Publication History

Received: May 06, 2020

Accepted: April 16, 2021

Published: May 20, 2021


Abstract


Background: The clinical syndrome of headache and neurological deficits and cerebrospinal fluid lymphocytosis (HaNDL) is recognized as a self-limiting condition consisting of discrete episodes of neurological deficit associated with moderate to severe headache. The spectrum of neurological features most commonly include aphasia, sensory, and motor disturbances. However, confusion and agitation has also been described. Case Presentation: We present an unusual case of a 28-year-old male with recurrent hospital presentations for headache, confusion, and other neurological stigmata over a period of 15 days, culminating in a diagnosis of HaNDL following extensive investigations. He was treated empirically for viral encephalitis initially; however, there were no positive results on virology screening. In addition, autoimmune screens were also negative. He was then managed symptomatically and discharged from hospital with resolution of symptoms thereafter. Conclusion: The differential diagnoses for transient acute confusional disorders remain expansive, with HaNDL being one of the many rare causes. Rigorous testing is required to exclude infective, inflammatory, ischemic, structural, or iatrogenic pathology, whil HaNDL primarily remains a diagnosis of exclusion.

Keywords: HaNDL, confusion, headache, behavioral changes, CSF lymphocytosis, neurological deficits, green


Pubmed Style

Annaliese Stolz, Rachel Efendy, Yogesh Apte. Headache, confusion, and behavioral changes - a HaNDL case report. EJMCR. 2021; 20 (May 2021): 133-137. doi:10.24911/ejmcr/173-1588758405

Web Style

Annaliese Stolz, Rachel Efendy, Yogesh Apte. Headache, confusion, and behavioral changes - a HaNDL case report. https://ejmcr.com/articles/1314 [Access: December 25, 2024]. doi:10.24911/ejmcr/173-1588758405

AMA (American Medical Association) Style

Annaliese Stolz, Rachel Efendy, Yogesh Apte. Headache, confusion, and behavioral changes - a HaNDL case report. EJMCR. 2021; 20 (May 2021): 133-137. doi:10.24911/ejmcr/173-1588758405

Vancouver/ICMJE Style

Annaliese Stolz, Rachel Efendy, Yogesh Apte. Headache, confusion, and behavioral changes - a HaNDL case report. EJMCR. (2021), [cited December 25, 2024]; 20 (May 2021): 133-137. doi:10.24911/ejmcr/173-1588758405

Harvard Style

Annaliese Stolz, Rachel Efendy, Yogesh Apte (2021) Headache, confusion, and behavioral changes - a HaNDL case report. EJMCR, 20 (May 2021): 133-137. doi:10.24911/ejmcr/173-1588758405

Chicago Style

Annaliese Stolz, Rachel Efendy, Yogesh Apte. "Headache, confusion, and behavioral changes - a HaNDL case report." 20 (2021), 133-137. doi:10.24911/ejmcr/173-1588758405

MLA (The Modern Language Association) Style

Annaliese Stolz, Rachel Efendy, Yogesh Apte. "Headache, confusion, and behavioral changes - a HaNDL case report." 20.May 2021 (2021), 133-137. Print. doi:10.24911/ejmcr/173-1588758405

APA (American Psychological Association) Style

Annaliese Stolz, Rachel Efendy, Yogesh Apte (2021) Headache, confusion, and behavioral changes - a HaNDL case report. , 20 (May 2021), 133-137. doi:10.24911/ejmcr/173-1588758405