![]() A CSF culture did not detect bacterial growth. ![]() CSF opening pressure was 20 cm H 2O, and a biochemical analysis revealed pleocytosis (525 cells/μL, mostly lymphocytes ), elevated protein levels (98.2 mg/dL), and lack of glucose consumption. Eye fundus examination did not reveal signs of intracranial hypertension, and a head CT scan detected no relevant alterations. Blood analysis did not reveal elevated levels of acute-phase reactants or blood count alterations, and a urine toxicology screening test yielded negative results. The patient was asymptomatic and haemodynamically stable, and presented no fever. He had not presented fever or any other systemic symptoms in the previous days, but in the previous month he had presented a mild upper respiratory tract infection, with odynophagia and mild fever, and a PCR test had yielded positive results for SARS-CoV-2. We present the case of a 14-year-old boy with no relevant personal or family history who visited the emergency department due to an episode of sudden-onset, moderate-intensity holocranial pulsatile headache, associated with nausea, photo- and phonophobia, and language impairment in the form of paraphasia and blocking. The aetiopathogenic mechanism of HaNDL syndrome is unclear, although the condition is thought to be a transient inflammatory process caused by an immune response to viral infection (e.g., HHV-7, EBV, CMV, HHV-6) 3–6 or other pathogens this would trigger the production of antibodies and/or inflammatory cytokines, which would act on leptomeningeal vessels, 1 causing vasoconstriction and vasodilation. 1 Diagnosis is confirmed by predominantly lymphocytic pleocytosis and normal results in other complementary tests. Headache and neurological deficits with cerebrospinal fluid (CSF) lymphocytosis, also known as HaNDL syndrome, is characterised by episodes of migraine-like headache associated with motor, sensory, or language deficits lasting several hours and recurring within less than 3 months. Neurology Perspectives is a platform for scientific information whose quality is recognized by professionals interested in neurology articles published in English and Spanish. The article formats include Editorials, Original Articles, Review Articles, Scientific letters and Letters to the Editor. The articles are selected based on their quality, originality and interest, then undergo a process for their improvement. The articles published in Neurology Perspectives are evaluated in a double-blind review process. ![]() The subject areas of the Journal include pediatric neurology, neuropsychology, neurorehabilitation and geriatric neurology. The overriding criteria for publication are originality, a high scientific quality and interest to a wide audience of those concerned with all aspects of neurology. The journal complies with the International Committee of Medical Journal Editor's Uniform Requirements for Manuscripts (detailed examples available at: ). The content of Neurology Perspectives covers everything from neuroepidemiology, clinical neurology, neurological management and care/therapy, to basic neuroscience research applied to neurology. Neurology Perspectives is a gold open access journal from the Sociedad Española de Neurología (Spanish Neurology Society). ![]()
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