Headache with a neurological deficit and cerebrospinal fluid (CSF) lymphocytosis (HaNDL) is usually under-recognized and under-reported. HaNDL is a self-limiting condition, but the grave symptoms require a large-scale differential diagnosis. We report a case of a 24-year-old female who developed dysarthria for several hours and decreased use of the right arm with right-sided facial weakness. After extensive investigation of blood, CSF, and neuroimaging, we excluded central nervous system infections and autoimmune and vascular diseases. A diagnosis of HaNDL was made according to clinical symptoms and CSF analysis. The prognosis was good, and the symptoms resolved. Repeated physical examination after 48 h was unremarkable. HaNDL is probably not as rare as commonly thought; awareness of its existence can avoid unnecessary and potentially harmful investigations and therapies. The clinical challenge relies on the fact that it remains a diagnosis of exclusion.

中文翻译：

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一名患有短暂性头痛、神经功能缺损和淋巴细胞增多症（HaNDL 综合征）并伴有脑内黑变病的成年女性：病例报告

伴有神经功能缺损和脑脊液 (CSF) 淋巴细胞增多 (HaNDL) 的头痛通常未被充分认识和报告。HaNDL 是一种自限性疾病，但严重的症状需要大规模的鉴别诊断。我们报告了一例 24 岁女性的病例，她出现构音障碍数小时，右臂的使用减少，右侧面部无力。在对血液、脑脊液和神经影像学进行广泛调查后，我们排除了中枢神经系统感染以及自身免疫性和血管疾病。根据临床症状和脑脊液分析做出 HaNDL 的诊断。预后良好，症状消失。48 小时后复查身体无异常。HaNDL 可能并不像人们普遍认为的那样罕见。意识到它的存在可以避免不必要的和潜在有害的调查和治疗。临床挑战依赖于这样一个事实，即它仍然是一种排除性诊断。