Background & objectives:
@EN Hypertensive encephalopathy is an acute neurologic syndrome characterized by abrupt and marked elevation of blood pressure, headache, vomiting, seizure, visual disturbances, and altered mental status. This syndrome may occur as a complication
of
toxemia, renal artery stenosis and acute glomerulonephritis. We report 4 young patients with occipital lobe seizure, as a presenting sign of hypertensive encephalopathy, whose brain MRI and perfusion scans showed lesions on bilateral occipital
lobes.
@ES Case:
@EN Four young patients experienced moderate to severe headache, visual illusion, generalized seizure, and loss of sight for a few days. Their systolic blood pressure was 150-170mmHg and diastolic blood pressure 100-120mmHg. Three patients had
proteinuria and hematuria as the results of acute glomerulonephritis. CSF findings were within normal limits. EEG showed intermittent generalized or bilateral temporoparietooccipital slowings in all patients and continuous parietooccipital
slowings
in
one patient. Brain MRI scan showed hyperintensity signal in T2WI and hypointensity signal in T1WI on bilateral occipital lobes, and SPECT scan showed normal perfusion in three patients and increased perfusion on occipital areas in one patient.
They
were
treated with antihypertensive agents and anticonvulsants (phenobarbital or valporic acid) for 2-10 months. Seizure was well controlled, and didn't recur though discontinuing anticonvulsant.
@ES Conclusions:
@EN In young age, acute hypertension may cause clinically occipital lobe seizure and radiologically bilateral occipital lobe lesions.
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