Seizures, Hypertension, and Posterior Leukoencephalopathy BT - Seizures: Medical Causes and Management

Abstract

Seizures may be associated with hypertension in two ways. First, chronic hypertension is a risk factor for vascular disease, thus predisposing to both obvious and subclinical cerebrovascular disease. Such disease is a strong risk factor for late-onset seizures and epilepsy in the elderly (1). The second peak of epilepsy incidence that occurs in the elderly is appreciated more now than previously, and this is likely to become a greater problem as more people live to old age. Second, hypertension may also be complicated by hypertensive encephalopathy, a hypertensive emergency (2). This may or may not occur in the setting of preexisting known hypertension. Acute symptomatic seizures are a common clinical feature of hypertensive encephalopathy. A clinicoradiological syndrome, known as reversible posterior leukoencephalopathy is recognized in this setting, although this also can occur apparently unrelated to acute hypertension. In addition, reversible posterior leukoencephalopathy may have a number of overlapping and interacting causes.