Occipital lobe seizure due to hypertensive encephalopathy in youth

J Korean Neurol Assoc > Volume 15(3); 1997 > Article

Journal of the Korean Neurological Association 1997;15(3): 650-659.

소년기 고혈압성 뇌병증에 의한 후두엽발작

윤성민, 이상원, 김광수, 유경무, 이창연

고신대학교 의과대학 신경과학교실. 소아과학교실*

Occipital lobe seizure due to hypertensive encephalopathy in youth

Sung Min Yoon, M.D., Sang Won Yi, M.D., Kwang Soo Kim, M.D., Kyung Mu Yoo, M.D., Chang Youn Lee, M.D.*

Department of Neurology and Pediatrics*, Kosin Medical Center

Abstract

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.