Clinical experience of childhood hypertensive encephalopathy over an eight year period.
BACKGROUND
Hypertensive encephalopathy is an uncommon neurological syndrome in children, usually with reversible clinical and neuroimaging findings. Little is known about the precipitating factors, clinical presentations, neuroimaging findings and outcomes of childhood hypertensive encephalopathy in Taiwan.


METHODS
To characterize this syndrome, we retrospectively analyzed 12 children with hypertensive encephalopathy in a tertiary institution from 1998 through 2005. We investigated the precipitating factors, clinical findings, courses, neuroimaging characteristics and outcomes.


RESULTS
Twelve patients (10 boys and 2 girls) with hypertensive encephalopathy were identified. Post-streptococcal glomerulonephritis was the most common precipitating underlying disease. Common clinical presentations included mental change (100%), seizure (91.6%), headache (66.6%), nausea or vomiting (75%), and blurred vision (41.6%). Brain imaging studies showed vasogenic edema over the bilateral parietal, occipital and parasagittal regions, or the cerebellum. All patients had a reversible clinical course.


CONCLUSIONS
Hypertensive encephalopathy is predominant in males, and mental change is the most common clinical presentation. Renal origin is a common precipitating factor. A characteristic lesion of hypertensive encephalopathy is occipitoparietal region edema. The overall clinical outcome is good after prompt treatment.
Division of Pediatric Critical Care and Emergency Medicine, Chang Gung Children's Hospital, Taipei, Taiwan, R.O.C.
Mei-Hua
MH
Hu
Huei-Shyong
HS
Wang
Kuang-Lin
KL
Lin
Jing-Long
JL
Huang
Shao-Hsuan
SH
Hsia
Ming-Liang
ML
Chou
Po-Cheng
PC
Hung
Meng-Ying
MY
Hsieh
Alex Mun-ching
AM
Wong
D000293:Adolescent; D001921:Brain / Q000000981:diagnostic imaging; D002648:Child; D004569:Electroencephalography; D005260:Female; D006801:Humans; D020343:Hypertensive Encephalopathy / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology; D008279:Magnetic Resonance Imaging; D008297:Male; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed