ABSTRACT
The syndrome of transient headache and neurologic deficits with cerebrospinal fluid lymphocytosis (HaNDL), is a rare, benign, self-limiting syndrome that is not well known. Cerebrospinal fluid examination (CSF) on clinical suspicion has diagnostic value for this syndrome, which has a rich neurological symptomatology that can mimic many diseases causing mortality and morbidity. Although the ethiopathogenesis of this syndrome is not fully known, autoimmunity is thought to be in the foreground. Described in this article is a HaNDL case that on first clinic presentation appeared to be a transient ischemic attack (TIA) with temporary but recurring neurological findings and normal CSF pressure accompanied by papilledema. Clinical features, epidemiology, ethiopathogenesis, differential diagnosis, and treatment of this syndrome are reviewed according to the literature.
Subject(s)
Headache/diagnosis , Papilledema/diagnosis , Diagnosis, Differential , Headache/cerebrospinal fluid , Headache/diagnostic imaging , Humans , Ischemic Attack, Transient/diagnosis , Magnetic Resonance Imaging , Male , Middle Aged , Papilledema/cerebrospinal fluid , Papilledema/diagnostic imaging , Syndrome , Tomography, X-Ray ComputedSubject(s)
Immunotherapy/methods , Psychotic Disorders/immunology , Psychotic Disorders/therapy , Adolescent , Humans , Male , Treatment OutcomeABSTRACT
AIM: To determine the frequency and topographic distribution of cerebral microbleeds (CMBs) in dementia with Lewy bodies (DLB) in comparison to CMBs in Alzheimer disease dementia (AD). METHODS: Consecutive probable DLB (n = 23) patients who underwent 3-T T2* weighted gradient-recalled-echo MRI, and age and gender matched probable Alzheimer's disease patients (n = 46) were compared for the frequency and location of CMBs. RESULTS: The frequency of one or more CMBs was similar among patients with DLB (30%) and AD (24%). Highest densities of CMBs were found in the occipital lobes of patients with both DLB and AD. Patients with AD had greater densities of CMBs in the parietal, temporal lobes and infratentorial regions compared to DLB (p < 0.05). CONCLUSION: CMBs are as common in patients with DLB as in patients with AD, with highest densities observed in the occipital lobes, suggesting common pathophysiologic mechanisms underlying CMBs in both diseases.
