Clinical Experience of Childhood Hypertensive Encephalopathy over an Eight Year Period

Background: Hypertensive encephalopathy is an uncommon neurological syndrome inchildren, usually with reversible clinical and neuroimaging findings. Little isknown about the precipitating factors, clinical presentations, neuroimagingfindings and outcomes of childhood hypertensive encephalopathy in Taiwan.Methods: To characterize this syndrome, we retrospectively analyzed 12 children withhypertensive encephalopathy in a tertiary institution from 1998 through2005. We investigated the precipitating factors, clinical findings, courses,neuroimaging characteristics and outcomes.Results: Twelve patients (10 boys and 2 girls) with hypertensive encephalopathy wereidentified. Post-streptococcal glomerulonephritis was the most common precipitatingunderlying disease. Common clinical presentations included mentalchange (100%), seizure (91.6%), headache (66.6%), nausea or vomiting(75%), and blurred vision (41.6%). Brain imaging studies showed vasogenicedema over the bilateral parietal, occipital and parasagittal regions, or thecerebellum. All patients had a reversible clinical course.Conclusion: Hypertensive encephalopathy is predominant in males, and mental change isthe most common clinical presentation. Renal origin is a common precipitatingfactor. A characteristic lesion of hypertensive encephalopathy is occipitoparietalregion edema. The overall clinical outcome is good after prompttreatment.