J Korean Neurol Assoc.
1997 Jun;15(3):650-659.
Occipital lobe seizure due to hypertensive encephalopathy in youth
- Affiliations
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- 1Department of Neurology, Kosin Medical Center.
- 2Department of Pediatrics, Kosin Medical Center.
Abstract
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BACKGROUND & OBJECTIVES: Hypertensive encephalopathy is an acute neurologic syndrome characterized by abrupt and marked elevation of blood pressure, headache, vomiting, seizure, visual disturbance, 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 encephatopathy, whose brain MRI and perfusion scans showed lesions on bilateral occipital lobes. Case : 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 generali,ed or bilateral temporoparietooccipital slowings in all patients and continuous parietooccipital slowings in one patient. Brain MRI man showed hyperintensity signal in T2WI and hypointensity signal in TlWl on bilateral occipital lobes and SPECT scan showed normal perfusion three patients and increased perfusion on occipital areas in one patient. They were treated with antihypertemsive agents and anticonvulsants (phenobarbital or valporic acid) for 2-10 months. Seizure was well controlled and didn't recur though discontinuing anticonvulsant.
CONCLUSION
In young age, acute hypertension may cause clinically occipital lobe seizure and radiologically bilateral occipital lobe lesions.
MeSH Terms
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Adolescent*
Anticonvulsants
Blood Pressure
Brain
Electroencephalography
Glomerulonephritis
Headache
Hematuria
Humans
Hypertension
Hypertensive Encephalopathy*
Illusions
Magnetic Resonance Imaging
Occipital Lobe*
Perfusion
Proteinuria
Renal Artery Obstruction
Seizures*
Tomography, Emission-Computed, Single-Photon
Toxemia
Vomiting
Anticonvulsants
