[Neurologic manifestations of arterial hypertension in children].
Neurological complications of arterial hypertension are analyzed in 31 children (mean age = 9 years). All patients presented a renal or renovascular disease (acute nephritis + hypoplastic dysplasia , transplantation = 58%) for which malignant hypertension was the first symptom in 16%. The mean +/- SD initial blood pressure was 189 +/- 33/113 +/- 25 mm Hg and was preceded by previous symptoms in 1 patient out of 6. Neurological abnormalities consisted in seizures (48%), acute intracranial hypertension (39%), cranial palsy (23%), coma (19%), hemiplegia/paresia (16%), retinal changes (6%) or aphasia (6%). The EEG was abnormal in 50% of the patients, sometimes showing permanent paroxysmal activity. Neuroradiologic investigations revealed hemorrhagic and/or ischemic lesions in 1/5 patients. On follow-up, hypertension disappeared in 41% of the children; a decrease in renal function was noted in 56% of the patients at the last examination; neurological sequellae were present in 40% (EEG anomalies +/- epilepsy, motor deficit, retinal changes, psychomotor delay, cranial palsy) and 1 patient died. The morbidity of malignant hypertension stresses the importance of early diagnosis and treatment (calcium channel blockers) when its prevention is not possible.
Cochat
P
P
Unité de néphrologie, Hôpital Edouard-Herriot, Lyon, France.
Delmas
M C
MC
de Parscau
L
L
Floret
D
D
Parchoux
B
B
Guibaud
P
P
David
L
L
Larbre
F
F
D000293:Adolescent; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D002493:Central Nervous System Diseases / Q000000981:diagnostic imaging / Q000209:etiology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D006974:Hypertension, Malignant / Q000150:complications* / Q000188:drug therapy; D006978:Hypertension, Renovascular / Q000150:complications* / Q000188:drug therapy; D016030:Kidney Transplantation; D008297:Male; D011859:Radiography; D012189:Retrospective Studies; D014786:Vision Disorders / Q000209:etiology
D002121:Calcium Channel Blockers
Manifestations neurologiques de l'hypertension artérielle chez l'enfant.