Del Giudice E, Aicardi J
Neuropadiatrie. 1979 May;10(2):150-7. doi: 10.1055/s-0028-1085321.
Four patients with hypertensive encephalopathy and misleading focal symptomatology are reported in order to point out the problems of differential diagnosis. The first patient, together with a classical syndrome of hypertensive encephalopathy, had peculiar EEG features consistent with a possible diagnosis of herpes simplex encephalitis. Case 2 presented with a complex clinical syndrome associating bizarre spells suggestive of a psychiatric condition with ocular symptoms pointing to an upper brain stem involvement. The third child was remarkable because of the presence of neuroradiological signs compatible with a space-occupying lesion of the posterior fossa not eventually found after a surgical exploration performed as an emergency procedure. The last patient had central nervous system signs in the context of a Guillain-Barré syndrome: in this case the central symptomatology would not fit the already described pattern of encephalomyelo-radiculo-neuropathy but had to be entirely ascribed to the ill controlled arterial hypertension.
本文报告了4例伴有误导性局灶症状的高血压脑病患者，以指出鉴别诊断的问题。首例患者除典型的高血压脑病综合征外，还具有特殊的脑电图特征，可能诊断为单纯疱疹性脑炎。病例2表现为复杂的临床综合征，包括提示精神疾病的怪异发作以及提示上脑干受累的眼部症状。第三个患儿很特别，因为存在与后颅窝占位性病变相符的神经放射学征象，但紧急手术探查后最终未发现占位性病变。最后1例患者在吉兰 - 巴雷综合征背景下出现中枢神经系统症状：在这种情况下，中枢症状不符合已描述的脑脊髓神经根神经病模式，而必须完全归因于未得到有效控制的动脉高血压。
