{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T14:20:17Z","timestamp":1793715617672,"version":"4.6.1"},"reference-count":11,"publisher":"Aerospace Medical Association","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:p>\n                    <jats:bold>BACKGROUND:<\/jats:bold>\n                    The syndrome of transient headache and neurological deficits with cerebrospinal fluid lymphocytosis (HaNDL syndrome) consists of migraine-like headache episodes with &gt;4 h of hemiparesthesia, dysphasia, and\/or hemiparesis plus cerebrospinal fluid lymphocytic pleocytosis. While the rarity of HaNDL syndrome often precludes reassurance of the nature of this syndrome, it has consistently been identified as a benign condition that lasts no longer than 3 mo.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>CASE REPORT:<\/jats:bold>\n                    In the first week of a viral illness, a 29-yr-old male helicopter pilot experienced acute-onset \u201cstumbling\u201d when walking, \u201cnonsensical speech,\u201d migraine-like headache, scintillating scotomata, and paresthesias of the tongue and bilateral extremities that lasted for 4\u20136 h. Work-up included lumbar puncture, revealing lymphocytic pleocytosis. A week later, he experienced word-finding difficulty, right-sided numbness\/paresthesia, and severe occipital headache lasting 3 h. A third episode with sensory symptoms involving the tongue and right arm and leg occurred for a few hours 25 d after the onset of the first episode. Symptoms resolved spontaneously. A month following initial discharge, he denied symptom recurrence. Repeat lumbar puncture 4 mo later showed resolution of his pleocytosis. He was considered neurologically recovered 3 mo after symptom onset.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>DISCUSSION:<\/jats:bold>\n                    This patient\u2019s transient episodes were consistent with HaNDL syndrome. His symptom resolution involving three episodes within 25 d reflects the transient nature of this condition. It is critical to recognize HaNDL syndrome as a benign, monophasic disorder that resolves within a maximum of 3 mo so that future pilots with a recent history of HaNDL syndrome may safely and expeditiously return to work.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>\n                      Wetmore EL, Haddon R, Robertson CE, Cowl CT, Elkhatib WY, Garza I.\n                      <jats:italic>Headache and neurological deficits with cerebrospinal fluid lymphocytosis in a helicopter pilot<\/jats:italic>\n                      . Aerosp Med Hum Perform. 2025; 96(10):936\u2013939.\n                    <\/jats:bold>\n                  <\/jats:p>","DOI":"10.3357\/amhp.6702.2025","type":"journal-article","created":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T21:29:09Z","timestamp":1763760549000},"page":"936-939","source":"Crossref","is-referenced-by-count":1,"title":["Headache and Neurological Deficits with Cerebrospinal Fluid Lymphocytosis in a Helicopter Pilot"],"prefix":"10.3357","volume":"96","author":[{"given":"Emma L.","family":"Wetmore","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Haddon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carrie E.","family":"Robertson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clayton T.","family":"Cowl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wiaam Y.","family":"Elkhatib","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivan","family":"Garza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1911","reference":[{"issue":"1","key":"B1","series-title":"Cephalalgia.","first-page":"1","article-title":"The international classification of headache disorders, 3rd edition","volume":"38","year":"2018","unstructured":"Headache Classification Committee of the International Headache Society (IHS). 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