Generalized Convulsions- a rare Presentation of HaNDL Syndrome |Biomedgrid

Headache with Neurologic Deficits and cerebrospinal fluid Lymphocytosis (HaNDL) syndrome is a rare entity related to migrainous headaches. It is a benign, self-limited disorder, which is characterized by transient neurological symptoms and cerebrospinal fluid lymphocytosis. The International Headache Society criteria requires, episodes involve migraine-like headache along with weakness, sensory changes, and/or aphasia lasting at least 4 hours. The cerebrospinal fluid is notably abnormal, with an elevated protein and lymphocyte count greater than 15 cells/μL. Episodes typically recur but resolve without long-term sequalae. The most frequent neurologic signs are hemiparesis, hemisensory disturbances, and aphasia. Electroencephalogram (EEG) studies have shown that patients with HaNDL may have non-specific non-epileptiform changes such as asymmetrical generalized slowing, intermittent rhythmic delta activity and triphasic waves on their EEG. On our literature review, there are no reports of convulsive seizures that have been reported as a symptom of HaNDL. Our patient met the diagnostic criteria of HaNDL but had a unique neurological symptom of convulsive seizures.