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"Stress" polycythaemia and peripheral facial palsy complications of severe hypertension

P M Zeis, S Rao, E G John

    Acta Paediatrica Scandinavica
    |March 1, 1979
    PubMed

    Insights

    Severe hypertension in an infant caused recurrent polycythemia and peripheral facial palsy. Controlling blood pressure resolved these neurological and hematological issues, highlighting the need for hypertension screening in facial palsy cases.

    Area of Science:

    • Pediatric Neurology
    • Clinical Hematology
    • Cardiovascular Medicine

    Background:

    • Peripheral facial palsy is a common neurological deficit in children.
    • Hypertension is a significant risk factor for various vascular and neurological complications.
    • Polycythemia, an elevated red blood cell count, can have diverse etiologies.

    Observation:

    • An 11-month-old boy presented with recurrent episodes of generalized convulsions and peripheral facial palsy.
    • Both episodes were associated with polycythemia and severe, unexplained hypertension.
    • Neurological deficits, including facial palsy, resolved with hypertension management.

    Findings:

    • The polycythemia was attributed to contracted plasma volume secondary to severe hypertension.
    • Peripheral facial palsy was likely caused by a facial canal thrombus, evidenced by preserved hearing and lacrimation.
    • Effective control of hypertension led to the resolution of facial palsy and normalization of hematocrit.

    Implications:

    • This case underscores a potential link between severe hypertension and recurrent peripheral facial palsy in pediatric patients.
    • Routine blood pressure monitoring is crucial in the diagnostic workup of children presenting with peripheral facial palsy.
    • Early identification and management of hypertension can prevent serious neurological and hematological complications.

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