Coccygeal fracture, constipation, convulsion, and confusion: A case reportof malignant hypertension in a child

Malignant hypertension is an unusual but well described cause of seizures i n pediatrics. It is a medical emergency that must be recognized and emergen tly treated to prevent morbidity and mortality. In contrast to adults, hype rtension 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 med ical literature described only one similar presentation (1). Interestingly, acute symptoms in this patient may have been precipitated by use of an ove r-the-counter medication.