Anti-neuronal antibodies associated with headache with neurological deficits and cerebrospinal fluid lymphocytosis

Excerpt

Infectious-immunogenic mechanisms have been proposed for the pathogenesis of the syndrome of transient headache and neurological deficits with cerebrospinal fluid lymphocytosis (HaNDL) [1]. To investigate this assumption, we performed immunohistochemistry and Western blot studies with sera and cerebrospinal fluid (CSF) of two HaNDL patients. Serum and CSF IgGs of both patients showed strong reactivity with the nuclei of rat central nervous system (CNS) cells and proteins extracted from neuroblastoma cells. This reactivity was not observed with samples of a sporadic hemiplegic migraine (SHM) patient and 12 migraine patients used as controls. The CNS binding pattern of HaNDL IgG was easily distinguishable from that of other well-known anti-neuronal nuclear antibodies (ANNA) such as anti-Hu, anti-Ri, and anti-nuclear antibody (ANA). The presence of an anti-neuronal immune response may support the autoimmune hypothesis as a pathogenic factor for HaNDL and should be further investigated in larger series. …