Confusional State in HaNDL Syndrome: Case Report and Literature Review

The syndrome of transient headache and neurologic deficits with cerebrospinal fluid lymphocytosis (HaNDL syndrome) is a self-limited condition. Confusional states are uncommonly reported as a clinical manifestation of this syndrome. Here, I report a 76-year-old female who presented with headache, confusion, and agitation with a mild CSF lymphocytosis. Other workup to determine the cause of her altered mental status was otherwise negative. The literature available in the English language on HaNDL syndrome is reviewed, including its history, pathophysiology, possible associations with migraine and stroke, and previously reported cases of confusional states in this syndrome. While HaNDL syndrome has been a described entity since the 1980s, its pathophysiology has yet to be clearly defined.

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Dexmedetomidine to Treat 3, 4-Methylenedioxymethamphetamine-Induced Agitation in a 13-Month-Old Infant: A Case Report and Literature Review

Journal of Pediatric Intensive Care ◽

10.1055/s-0039-1677815 ◽

2019 ◽

Vol 08 (03) ◽

pp. 175-177 ◽

Cited By ~ 1

Author(s):

Patricia J. L. T. Sanders ◽

Jan Hanot

Keyword(s):

Emergency Department ◽

Case Report ◽

Literature Review ◽

Mental Status ◽

Respiratory Insufficiency ◽

Altered Mental Status ◽

Clinical Recovery ◽

Multiple Doses ◽

First Case

AbstractWe report a 13-month-old infant who accidentally ingested a tablet of 3, 4-methylenedioxymethamphetamine (MDMA) and was brought to the emergency department with tachycardia, seizures, mydriasis, and altered mental status. The patient received multiple doses of benzodiazepines to treat the seizures and developed respiratory insufficiency needing intubation. After extubation, the patient developed hyperactivity, myoclonic, and choreoathetoid movements which were unresponsive to benzodiazepines. Dexmedetomidine was started with good response. The patient made a full clinical recovery. This is the first case that illustrates the possibility to treat MDMA-induced agitation with dexmedetomidine in a 13-month-old infant.

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Reticular erythematous mucinosis: Literature review and case report of a 24-year-old patient with systemic erythematosus lupus

Lupus ◽

10.1177/0961203320965702 ◽

2020 ◽

pp. 096120332096570

Author(s):

Juliana P Ocanha-Xavier ◽

Camila O Cola-Senra ◽

Jose Candido C Xavier-Junior

Keyword(s):

Systematic Review ◽

Case Report ◽

Literature Review ◽

English Language ◽

Case Reports ◽

Histopathological Diagnosis ◽

Skin Disorders ◽

Histopathological Findings ◽

Inflammatory Skin

Reticular erythematous mucinosis (REM) was first described 50 years ago, but only around 100 case reports in English have been published. Its relation with other inflammatory skin disorders is still being debated. We report a case of REM, including the clinical and histopathological findings. Also, a systematic review of 94 English-language reported cases is provided. The described criteria for clinical and histopathological diagnosis are highlighted in order to REM can be confidently diagnosed.

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Transient altered mental status and leptomeningeal enhancement associated with pembrolizumab: a case report

Neurological Sciences ◽

10.1007/s10072-021-05479-6 ◽

2021 ◽

Author(s):

Keng Lam ◽

Sameer K. Kulkarni ◽

Manya Khrlobyan ◽

Pamela K. Cheng ◽

Caroline L. Fong

Keyword(s):

Case Report ◽

Mental Status ◽

Altered Mental Status ◽

Leptomeningeal Enhancement

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Altered mental status with mirror giant middle cerebral artery aneurysms: A case report

Interdisciplinary Neurosurgery ◽

10.1016/j.inat.2021.101154 ◽

2021 ◽

pp. 101154

Author(s):

Kamil W. Nowicki ◽

Jasmine L. Hect ◽

Nallamai Muthiah ◽

Arka N. Mallela ◽

Benjamin M. Zussman

Keyword(s):

Case Report ◽

Middle Cerebral Artery ◽

Mental Status ◽

Cerebral Artery ◽

Altered Mental Status ◽

Middle Cerebral Artery Aneurysms

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Acute childhood encephalopathy with prolonged fever, pleocytosis and elevated inflammatory cytokines in the cerebrospinal fluid and transient splenial lesion

Journal of the International Child Neurology Association ◽

10.17724/jicna.2019.166 ◽

2019 ◽

Author(s):

Rena Okada ◽

Yuri Sakaguchi ◽

Takeshi Matsushige ◽

Isamu Kamimaki ◽

Toshiki Takenouchi ◽

...

Keyword(s):

Cerebrospinal Fluid ◽

Mental Status ◽

Nationwide Survey ◽

Altered Mental Status ◽

Acute Encephalopathy ◽

C Reactive Protein ◽

Reactive Protein ◽

Prolonged Fever ◽

Splenial Lesion ◽

Male Patients

Background: Acute encephalopathy during childhood represents a highly heterogeneous group of infectious and non-infectious pathologies. According to a recent nationwide survey on acute childhood encephalopathy in Japan, the combination of clinical and radiographic features left approximately half of the affected children unclassified, mainly because of the lack of disease-specific biomarkers. Case: Herein, we document a school-aged boy who manifested with acute encephalopathy that was characterized by a prolonged fever, altered mental status, urinary retention, and intention tremor lasting for more than a month. Accompanying features included syndrome of inappropriate secretion of antidiuretic hormone, pleocytosis with elevated interleukin-6 and interferon-gamma levels in the cerebrospinal fluid, and a transient splenial lesion on neuroimaging. No pathogens were identified, and C-reactive protein was negative throughout his clinical course. This constellation of clinical features was not compatible with any of the existing entities of acute pediatric encephalopathy. Discussion: Our retrospective literature review identified two additional school-aged male patients who exhibited highly similar clinical courses. The prolonged altered mental status with pleocytosis in the cerebrospinal fluid and a transient splenial lesion in the absence of serum inflammatory markers suggest a primary central nervous system pathology. Conclusion: This combination of features defines this presumably new group of acute childhood febrile encephalopathy with prolonged fever and ataxia in school-aged boys.

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Intravascular large B-cell lymphoma presenting with altered mental status: A case report

World Journal of Clinical Oncology ◽

10.5306/wjco.v10.i12.402 ◽

2019 ◽

Vol 10 (12) ◽

pp. 402-408

Author(s):

Christopher Robert D’Angelo ◽

Kimberly Ku ◽

Jessica Gulliver ◽

Julie Chang

Keyword(s):

Case Report ◽

B Cell ◽

Mental Status ◽

Cell Lymphoma ◽

B Cell Lymphoma ◽

Altered Mental Status ◽

Large B Cell Lymphoma ◽

Large B Cell

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Posterior Reversible Encephalopathy Syndrome (PRES) in Palliative Medicine: Case Report and Discussion

American Journal of Hospice and Palliative Medicine® ◽

10.1177/10499091211030465 ◽

2021 ◽

pp. 104990912110304

Author(s):

Jade Willey ◽

Steven J. Baumrucker

Keyword(s):

Case Report ◽

Mental Status ◽

Posterior Reversible Encephalopathy Syndrome ◽

Palliative Medicine ◽

Altered Mental Status ◽

Posterior Reversible Encephalopathy ◽

Reversible Encephalopathy ◽

Visual Disturbances

Posterior reversible encephalopathy syndrome (PRES) is associated with seizures, visual disturbances, headache, and altered mental status. Given its presentation, the diagnosis can be mistaken for other severe conditions. Palliative medicine consultants should be aware of PRES and be prepared to counsel families on the treatment and prognosis of this syndrome.

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A SINGLE CASE REPORT ON HYPERAMMONEMIA INDUCED BY VALPROATE MONOTHERAPY WITHOUT HEPATIC DYSFUNCTION

International Journal of Pharmacy and Pharmaceutical Sciences ◽

10.22159/ijpps.2017v9i4.8571 ◽

2017 ◽

Vol 9 (4) ◽

pp. 218 ◽

Cited By ~ 2

Author(s):

C. Prarthana Saraswathi ◽

J. Anu Rita ◽

S. Nambi

Keyword(s):

Case Report ◽

Mental Status ◽

Hepatic Dysfunction ◽

Single Case ◽

Bipolar Affective Disorder ◽

Mood Stabilizer ◽

Altered Mental Status ◽

Plasma Ammonia ◽

Manic Symptoms ◽

Single Case Report

Valproate is a commonly used mood stabilizer. One of the important and rare side effects of valproate is hyperammonemia leading to delirium and hepatic encephalopathy. Valproate-induced delirium is commonly mistaken for worsening of manic symptoms or psychosis. We hereby report a case of bipolar affective disorder who was on a therapeutic dose of valproate monotherapy developed altered mental status where we found elevated levels of plasma ammonia which decreased after the discontinuation of valproate and with normal levels of serum valproate, LFT’s, EEG and imagings. This case report emphasises on the need to consider plasma ammonia levels in patients with altered mental status receiving valproate in addition to other investigations.

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