{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T14:20:15Z","timestamp":1793715615136,"version":"4.6.1"},"reference-count":13,"publisher":"Springer Publishing Company","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Doct Nurs Pract"],"published-print":{"date-parts":[[2020,7,1]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Headache and Neurologic Deficits with cerebrospinal fluid Lymphocytosis (HaNDL) is a rare and underdiagnosed syndrome that mimics recurrent stroke, migraine with aura, and encephalitis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>Describe the presentation, clinical characteristics, and cerebrospinal fluid (CSF) findings in a patient with HaNDL and provide insight into the importance of the recognition of this syndrome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The authors describe a unique case of (HaNDL) during which the patient underwent three lumbar punctures over 26 days.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The authors demonstrate the natural course of CSF characteristics of a patient with HaNDL, with rising and falling lymphocyte counts. Additionally, the authors provide an example of the clinical presentation of HaNDL, with episodic attacks over the course of 1 month of migraine headache, hemibody paresthesias, hemibody weakness, and encephalopathy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>HaNDL is a headache syndrome mimicking viral encephalitis, migraine with aura, and recurrent cerebral ischemic events. While HaNDL is a diagnosis of exclusion, the syndrome's association with characteristic clinical and laboratory findings are important to recognize. Furthermore, a monophasic pattern of CSF lymphocytosis in HaNDL may be observed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Implications for Nursing<\/jats:title><jats:p>Increased recognition of this syndrome may help prevent unnecessary tests and treatments when patients present with recurrent episodes.<\/jats:p><\/jats:sec>","DOI":"10.1891\/jdnp-d-19-00045","type":"journal-article","created":{"date-parts":[[2020,7,3]],"date-time":"2020-07-03T00:04:36Z","timestamp":1593734676000},"page":"103-107","source":"Crossref","is-referenced-by-count":1,"title":["A Case Report: The CSF Characteristics of HaNDL Syndrome"],"prefix":"10.1891","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5031-6332","authenticated-orcid":false,"given":"Sarah E.","family":"McKay","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melanie R. F.","family":"Greenway","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"793","published-online":{"date-parts":[[2020,7,2]]},"reference":[{"key":"2020081712251663000_13.2.103.1","doi-asserted-by":"publisher","DOI":"10.21037\/atm.2017.03.18"},{"key":"2020081712251663000_13.2.103.2","doi-asserted-by":"publisher","DOI":"10.1177\/0883073818811546"},{"key":"2020081712251663000_13.2.103.3","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1016\/j.nrleng.2015.03.010","article-title":"HaNDL syndrome: Correlation between focal deficits topography and EEG or SPECT abnormalities in a series of 5 new cases","volume":"31","year":"2016","journal-title":"Neurolog\u00eda (English Edition)"},{"key":"2020081712251663000_13.2.103.4","doi-asserted-by":"publisher","DOI":"10.1177\/0333102417738202"},{"key":"2020081712251663000_13.2.103.5","doi-asserted-by":"publisher","DOI":"10.1007\/s10072-018-3517-9"},{"key":"2020081712251663000_13.2.103.6","doi-asserted-by":"publisher","DOI":"10.1177\/0333102414526070"},{"key":"2020081712251663000_13.2.103.7","doi-asserted-by":"publisher","DOI":"10.1007\/s10072-015-2194-1"},{"key":"2020081712251663000_13.2.103.8","unstructured":"Genetic and Rare Diseases Information Center. (2017, May). HaNDL syndrome . Retrieved from https:\/\/rarediseases.info.nih.gov\/diseases\/13277\/handl-syndrome"},{"key":"2020081712251663000_13.2.103.9","doi-asserted-by":"publisher","DOI":"10.1177\/0333102417738202"},{"key":"2020081712251663000_13.2.103.10","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3182a9585f"},{"key":"2020081712251663000_13.2.103.11","doi-asserted-by":"publisher","DOI":"10.1111\/rda.13387"},{"key":"2020081712251663000_13.2.103.12","doi-asserted-by":"publisher","DOI":"10.1155\/2013\/317685"},{"issue":"3","key":"2020081712251663000_13.2.103.13","doi-asserted-by":"crossref","first-page":"84","DOI":"10.14740\/jmc2419w","article-title":"How to HaNDL this case?","volume":"7","year":"2016","journal-title":"Journal of Medical Cases"}],"container-title":["Journal of Doctoral Nursing Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1891\/JDNP-D-19-00045","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,8,17]],"date-time":"2020-08-17T19:26:13Z","timestamp":1597692373000},"score":1,"resource":{"primary":{"URL":"http:\/\/connect.springerpub.com\/lookup\/doi\/10.1891\/JDNP-D-19-00045"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,7,1]]},"references-count":13,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2020,8,17]]},"published-print":{"date-parts":[[2020,7,1]]}},"alternative-id":["10.1891\/JDNP-D-19-00045"],"URL":"https:\/\/doi.org\/10.1891\/jdnp-d-19-00045","relation":{},"ISSN":["2380-9418","2380-9426"],"issn-type":[{"value":"2380-9418","type":"print"},{"value":"2380-9426","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,7,1]]}}}