Paroxysmal hypertension simulating pheochromocytoma

An eight year old child with intermittent attacks of hypertension and vomiting has been described, The blood pressure fell dramatically in response to Benzodioxane®, suggesting the presence of a pheochromocytoma, but this tumor was not found after an extensive exploratory laparotomy. The episodes of hypertension and vomiting together with the associated findings in this child of crying without tears, frequent blotching of the skin and excessive sweating and salivating are considered to be indications of an unusually labile autonomic nervous system. These latter characteristics were present in a younger sibling who also had an extremely labile blood pressure but who did not exhibit periodic attacks of hypertension and vomiting. A variety of agents were studied for their effects on the patient's signs and symptoms but none of these were demonstrated to have any therapeutic value.