BRIEF REPORT
Confusion as a presentation symptom of pseudomigraine with pleocytosis in a paediatric patient
Confusión como síntoma de presentación de una pseudomigraña con pleocitosis en un paciente pediátrico
V. Soto-Insuga
, L. López-Villanueva, M. Rodrigo, I. Mois Aroyo, R. Losada, L. Soriano-Guillén
Corresponding author
Servicio de Pediatría, Fundación Jiménez Díaz, Madrid, Spain
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"apellidos" => "Soriano-Guillén" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Pediatría, Fundación Jiménez Díaz, Madrid, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Confusión como síntoma de presentación de una pseudomigraña con pleocitosis en un paciente pediátrico" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2013-04-23" "fechaAceptado" => "2013-10-14" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec330023" "palabras" => array:6 [ 0 => "Headache and neurologic deficits with CSF Lymphocytosis" 1 => "Pseudomigraine with pleocytosis" 2 => "Migraine" 3 => "Confusional syndrome" 4 => "Agitation" 5 => "Electroencephalogram" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec330024" "palabras" => array:6 [ 0 => "Cefalea con déficits neurológicos transitorios con pleocitosis linfocitaria" 1 => "Pseudomigraña con pleocitosis" 2 => "Migraña" 3 => "Estado confusional" 4 => "Agitación" 5 => "Electroencefalograma" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Transient headache and neurological deficits with cerebrospinal fluid lymphocytic pleocytosis (HaNDL) syndrome is a rare condition of unknown origin that is characterized by episodes of severe headache, transient neurological deficits that recur over less than 3 months, and lymphocytic pleocytosis in CSF.</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">We report the case of a 14 year-old girl who presented with headache and vomiting that lasted 4 days, later combined with a clinical presentation of confusion, with a decrease in the level of consciousness, aphasia, peripheral facial paralysis, ataxia and fever for 24<span class="elsevierStyleHsp" style=""></span>hours. CSF analysis showed pleocytosis (110 cells/ml) and proteinorrachia (87<span class="elsevierStyleHsp" style=""></span>mg/dl). Electroencephalogram in the acute time showed generalized slowing, and later a focal slowing in the left hemisphere. She suffered 7 episodes of migraine (severe headache and vomiting) in the following two months, remaining asymptomatic thereafter.</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">This is the first paediatric case published in the literature that presents with an agitated and/or confused state. This condition must be considered in the differential diagnosis of patients with headache and acute altered level of consciousness, in order to avoid prolonged treatments or unnecessary invasive testing.</p>" ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">La cefalea con déficits neurológicos transitorios con pleocitosis linfocitaria en el líquido cefalorraquídeo (HaNDL) es una entidad poco frecuente y de etiología desconocida caracterizada por episodios de cefalea intensa, déficits neurológicos transitorios recurrentes durante 3 meses y pleocitosis linfocitaria.</p><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Presentamos el caso de una niña de 14 años con cefalea y vómitos de 4 días de evolución, asociando posteriormente confusión, disminución de conciencia, afasia, paresia facial periférica, ataxia y febrícula durante 24<span class="elsevierStyleHsp" style=""></span>h. El análisis del LCR mostró pleocitosis (110 leucocitos/ml) y proteinorraquia (87<span class="elsevierStyleHsp" style=""></span>mg/dl). El electroencefalograma mostraba enlentecimiento generalizado en el momento agudo y posteriormente actividad lenta focalizada izquierda. En los siguientes 2 meses presentó 7 nuevos episodios de cefalea migrañosa permaneciendo asintomática después.</p><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Es el primer caso pediátrico de HaNDL que se presenta como agitación y/o estado confusional. Esta entidad debe incluirse en el diagnóstico diferencial ante cuadros de cefalea y alteración de conciencia para evitar tratamientos prolongados o pruebas invasivas innecesarias.</p>" ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Soto-Insuga V, López-Villanueva L, Rodrigo M, Mois Aroyo I, Losada R, Soriano-Guillén L. Confusión como síntoma de presentación de una pseudomigraña con pleocitosis en un paciente pediátrico. An Pediatr (Barc). 2014;80:394-398.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:20 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "[1]" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pseudomigraña con pleocitosis en el líquido cefalorraquídeo o síndrome de cefalea y déficit neurológico transitorios con pleocitosis en el líquido cefalorraquídeo" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "S. Martín-Balbuena" 1 => "F.J. Arpa-Gutierrez" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Revisión histórica. Rev Neurol." 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 5 | 12 | 17 |
| 2024 October | 53 | 46 | 99 |
| 2024 September | 45 | 43 | 88 |
| 2024 August | 68 | 93 | 161 |
| 2024 July | 45 | 40 | 85 |
| 2024 June | 51 | 34 | 85 |
| 2024 May | 49 | 35 | 84 |
| 2024 April | 42 | 31 | 73 |
| 2024 March | 43 | 29 | 72 |
| 2024 February | 39 | 36 | 75 |
| 2024 January | 34 | 27 | 61 |
| 2023 December | 25 | 19 | 44 |
| 2023 November | 45 | 20 | 65 |
| 2023 October | 41 | 17 | 58 |
| 2023 September | 28 | 21 | 49 |
| 2023 August | 21 | 24 | 45 |
| 2023 July | 39 | 23 | 62 |
| 2023 June | 40 | 42 | 82 |
| 2023 May | 47 | 24 | 71 |
| 2023 April | 34 | 19 | 53 |
| 2023 March | 39 | 25 | 64 |
| 2023 February | 37 | 12 | 49 |
| 2023 January | 45 | 32 | 77 |
| 2022 December | 55 | 28 | 83 |
| 2022 November | 41 | 31 | 72 |
| 2022 October | 42 | 45 | 87 |
| 2022 September | 20 | 34 | 54 |
| 2022 August | 33 | 56 | 89 |
| 2022 July | 38 | 44 | 82 |
| 2022 June | 35 | 42 | 77 |
| 2022 May | 37 | 37 | 74 |
| 2022 April | 42 | 43 | 85 |
| 2022 March | 52 | 65 | 117 |
| 2022 February | 41 | 40 | 81 |
| 2022 January | 47 | 42 | 89 |
| 2021 December | 32 | 60 | 92 |
| 2021 November | 37 | 70 | 107 |
| 2021 October | 53 | 80 | 133 |
| 2021 September | 55 | 76 | 131 |
| 2021 August | 26 | 47 | 73 |
| 2021 July | 30 | 42 | 72 |
| 2021 June | 35 | 44 | 79 |
| 2021 May | 55 | 41 | 96 |
| 2021 April | 130 | 25 | 155 |
| 2021 March | 52 | 36 | 88 |
| 2021 February | 21 | 19 | 40 |
| 2021 January | 19 | 24 | 43 |
| 2020 December | 29 | 19 | 48 |
| 2020 November | 19 | 19 | 38 |
| 2020 October | 24 | 12 | 36 |
| 2020 September | 13 | 16 | 29 |
| 2020 August | 19 | 27 | 46 |
| 2020 July | 14 | 31 | 45 |
| 2020 June | 19 | 27 | 46 |
| 2020 May | 21 | 28 | 49 |
| 2020 April | 24 | 21 | 45 |
| 2020 March | 30 | 22 | 52 |
| 2020 February | 32 | 19 | 51 |
| 2020 January | 26 | 18 | 44 |
| 2019 December | 24 | 40 | 64 |
| 2019 November | 17 | 17 | 34 |
| 2019 October | 26 | 25 | 51 |
| 2019 September | 18 | 16 | 34 |
| 2019 August | 25 | 22 | 47 |
| 2019 July | 19 | 17 | 36 |
| 2019 June | 28 | 29 | 57 |
| 2019 May | 25 | 28 | 53 |
| 2019 April | 100 | 32 | 132 |
| 2019 March | 26 | 16 | 42 |
| 2019 February | 30 | 20 | 50 |
| 2019 January | 18 | 27 | 45 |
| 2018 December | 32 | 31 | 63 |
| 2018 November | 38 | 35 | 73 |
| 2018 October | 33 | 21 | 54 |
| 2018 September | 23 | 22 | 45 |
| 2018 June | 2 | 0 | 2 |
| 2018 May | 3 | 0 | 3 |
| 2018 April | 9 | 0 | 9 |
| 2018 March | 14 | 0 | 14 |
| 2018 February | 5 | 0 | 5 |
| 2018 January | 10 | 0 | 10 |
| 2017 December | 7 | 0 | 7 |
| 2017 November | 10 | 0 | 10 |
| 2017 October | 8 | 0 | 8 |
| 2017 September | 7 | 0 | 7 |
| 2017 August | 11 | 0 | 11 |
| 2017 July | 9 | 2 | 11 |
| 2017 June | 16 | 15 | 31 |
| 2017 May | 23 | 11 | 34 |
| 2017 April | 25 | 29 | 54 |
| 2017 March | 12 | 7 | 19 |
| 2017 February | 14 | 10 | 24 |
| 2017 January | 8 | 3 | 11 |
| 2016 December | 21 | 8 | 29 |
| 2016 November | 24 | 10 | 34 |
| 2016 October | 39 | 9 | 48 |
| 2016 September | 29 | 8 | 37 |
| 2016 August | 23 | 8 | 31 |
| 2016 July | 15 | 3 | 18 |
| 2016 March | 4 | 0 | 4 |
| 2015 December | 5 | 0 | 5 |
| 2015 November | 2 | 11 | 13 |
| 2015 October | 2 | 17 | 19 |
| 2015 September | 1 | 0 | 1 |
| 2015 July | 8 | 11 | 19 |
| 2015 June | 1 | 0 | 1 |
| 2015 May | 1 | 0 | 1 |
| 2015 March | 2 | 0 | 2 |
| 2015 February | 1 | 0 | 1 |
| 2015 January | 1 | 0 | 1 |
| 2014 December | 2 | 1 | 3 |
| 2014 November | 2 | 0 | 2 |
| 2014 October | 2 | 0 | 2 |
| 2014 September | 2 | 0 | 2 |
| 2014 August | 2 | 0 | 2 |
| 2014 July | 4 | 0 | 4 |
| 2014 June | 17 | 1 | 18 |
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