Paroxysmal Hypertension: A Grave Cause

A 62-year-old lady was referred with the diagnosis of hypertensive encephalopathy. She had episodes of paroxysms of hypertension while on the ventilator with normal saturations. She underwent a battery of tests to identify the cause of the paroxysms. Eventually, a very unusual cause was found that should have been identified if the label of hypertensive encephalopathy had not been put at the beginning. A diligent history and examination remain important even in the modern day with high-technology care.