Headache And CSF

Question 1

What the DD s for a child presenting with headaches, limb weakness and abnormal sensation?

Answer 1

Todd’s paresis, TIA and hemiplegic migraine.

Rare causes: alternating hemiplegia of childhood, HaNDL syndrome

Question 2

What is HaNDL syndrome?

Answer 2

Affects usually adults
CSF lymphocytic pleocytosis with raised opening pressures.
Normal imaging and EEG.

Question 3

What are the non-infective causes of CSF raised protein?

Answer 3

MS
Polyneuropathy
HaNDL
Cerebral haemorrhage 
CIDP
Malignancy

Question 4

What are the non-infective causes of low CSF glucose?

Answer 4

Glucose transporter deficiency syndrome
LCM
Sarcoidosis
SLE
Neoplastic
Leptomeningeal metastasis
CNS leukaemia 
SAH

Question 5

What can cause unilateral optic disc swelling?

Answer 5

Not all disc swellings are papilledema.

Unilateral infiltrates of optic nerve

Question 6

What is JXG?

Answer 6

Juvenile xanthogranuloma.
Non-Langerhan cell histiocytic proliferative process.
Typically presents in first 2 years of age with benign skin lesions- solitary red or yellow papule or nodule.
Seen in head, neck and trunk region.