HaNDL syndrome after COVID-19

Transient Headache and Neurological Deficits with Cerebrospinal Fluid Lymphocytosis following COVID-19

“…1,2 The syndrome of headache and neurologic deficit with cerebrospinal fluid lymphocytosis (HaNDL) is a unique phenotype commonly associated with viral infection but with only one case reported following COVID-19 infection to date. 3 We report a second case and an approach to patients presenting with headache and focal neurological symptoms after COVID-19 (Figure 1).…”

“…10 To date, there is only one other report of HaNDL following COVID-19 infection. 3 Headache is a common symptom of both active COVID-19 infection and in the postinfectious period, 1,2 with several proposed mechanisms including inflammation, cytokine release, endothelial dysfunction, raised intracranial pressure, and venous congestion. 1,10 The absence of detectable virus in inflammatory CSF of patients with neurological symptoms supports an indirect autoimmune mechanism.…”