Illustrative Case: PDF OnlyCoccygeal fracture, constipation, convulsion, and confusion A case report of malignant hypertension in a childZGURZYNSKI, PAUL MD; MANNO, MARIANN MDAuthor Information From the University of Massachusetts Medical Center, Department of Emergency Medicine, Worcester. Pediatric Emergency Care: December 1999 - Volume 15 - Issue 6 - p 425-428 Buy Abstract Malignant hypertension is an unusual but well described cause of seizures in pediatrics. It is a medical emergency that must be recognized and emergently treated to prevent morbidity and mortality. In contrast to adults, hypertension in children is usually secondary to an underlying disease process. We present a complex case of hypertensive encephalopathy with seizures as the initial presentation of a pelvic mass, describe the initial work-up and stabilization and present an overview of the literature. Review of the medical literature described only one similar presentation (1). Interestingly, acute symptoms in this patient may have been precipitated by use of an over-the-counter medication. © 1999 Lippincott Williams & Wilkins, Inc.