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Hypertension Presenting As Bell's Palsy in Children
Authors: Dr. Karn Singh1, Dr. Gazal Srivastava2, Dr. Pooja Kumari3, Dr. Gajendra Kumar Vats4
Number of views: 92
Background Bell's palsy is a rare symptom of hypertension. We describe a case of childhood hypertension
of underlying renovascular etiology presenting as recurrent Bell's palsy.
Case Presentation A 2-year-old male was admitted to hospital for severe hypertension. His solepresenting
symptom was recurrent episodes of Bell's palsy The elevated blood pressure was noted incidentally during
anaesthesia assessment for magnetic resonance imaging of the brain. He was otherwise healthy, and had not
had blood pressure measuremented during assessments prior to hospitalilization. On admission, blood
pressure was 220/120 mm Hg, with evidence for moderate concentric left ventricular hypertrophy indicating
both a chronic process and end organ damage from his hypertension. The patient's blood pressure was
initially managed with labetalol and nitroprusside, and later he was converted to enalapril (0.5 mg/kg/day),
amlodipine (0.5 mg/kg/day), minoxidil (0.625 mg/kg/day) and metoprolol (2.5 mg/kg/day). A duplex right
kidney with stenosis of the cranial of the two renal arteries was diagnosed using 99mTc MAG3 scintigraphy
with ACE inhibitor, Doppler renal ultrasound and MR angiography.) The patient is awaiting angiography for
further management while being normotensive on the medications named above.