Renal Artery Stenosis Presenting with Status Epilepticus: A Report of One Case

Abstract

In children, renal artery stenosis is an uncommon but important cause of secondary hypertension. In this report, the authors describe a 5-year-old boy with no history of seizures who experienced status epilepticus. Postictal blood pressure, relative hypotension, was misinterpreted as normal on the day of admission. Two days later, his blood pressure rose gradually and peripheral plasma renin activity showed more than 1,700 U/mL. Magnetic resonance angiography suggested renal artery stenosis. After successful percutaneous transluminal angioplasty, the patient was seizure-free and had well-controlled blood pressure. This case describes renal artery stenosis present with status epilepticus, and emphasizes the importance of serial measurements of blood pressure in children.

A Suggested Approach to the Etiologic Evaluation of Status Epilepticus in Children: What to Seek After the Usual Causes Have Been Ruled Out

“…Systemic lupus erythematosus, though often associated with epilepsy, has occasionally been reported to present with status epilepticus in adults and quite rarely in children. 40,41 An interesting case of status as the presenting symptom of hypertensive encephalopathy due to renal artery stenosis was described by Chen et al 42 This 5 year old showed normal blood pressure values following the event, presumably a postictal phenomena. Within days, blood pressure raised markedly leading to the diagnosis of renal artery stenosis.…”