title: Atypical aspects of hypertensive encephalopathy in childhood.
abstract: Four patients with hypertensive encephalopathy and misleading focal symptomatology are reported in order to point out the problems of differential diagnosis. The first patient, together with a classical syndrome of hypertensive encephalopathy, had peculiar EEG features consistent with a possible diagnosis of herpes simplex encephalitis. Case 2 presented with a complex clinical syndrome associating bizarre spells suggestive of a psychiatric condition with ocular symptoms pointing to an upper brain stem involvement. The third child was remarkable because of the presence of neuroradiological signs compatible with a space-occupying lesion of the posterior fossa not eventually found after a surgical exploration performed as an emergency procedure. The last patient had central nervous system signs in the context of a Guillain-Barré syndrome: in this case the central symptomatology would not fit the already described pattern of encephalomyelo-radiculo-neuropathy but had to be entirely ascribed to the ill controlled arterial hypertension.
mesh_terms: D000293:Adolescent; D001766:Blindness / Q000175:diagnosis; D001927:Brain Diseases / Q000175:diagnosis*; D001929:Brain Edema / Q000175:diagnosis; D002543:Cerebral Hemorrhage / Q000175:diagnosis; D002648:Child; D002675:Child, Preschool; D003244:Consciousness Disorders / Q000175:diagnosis; D003937:Diagnosis, Differential; D004569:Electroencephalography; D004827:Epilepsy / Q000175:diagnosis; D005133:Eye Movements; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications*; D006977:Hypertension, Renal / Q000150:complications; D006978:Hypertension, Renovascular / Q000150:complications; D008297:Male; D014057:Tomography, X-Ray Computed