Scalp Acupuncture Facilitating Blood Pressure Control in Pediatric Hypertensive Encephalopathy: A Case Report

Background: Hypertensive encephalopathy (HE) in pediatric patients is a life-threatening condition requiring prompt and controlled blood pressure reduction to prevent neurological complications. Case Illustration: We report a 7-year-old child with chronic kidney disease on continuous ambulatory peritoneal dialysis who presented with HE complicated by seizures and persistent hypertension despite intravenous nicardipine and multiple oral antihypertensive agents. Adjunctive manual scalp acupuncture was initiated using GV20 (Baihui) , EX-HN1 (Sishencong) , and additional ashi points. Results: Following treatment, the patient demonstrated a progressive reduction in blood pressure over seven sessions, accompanied by resolution of seizures, improvement in sleep, and reduction of associated symptoms such as neck pain. This improvement enabled gradual de-escalation of intravenous nicardipine and transition to oral therapy. No recurrent neurological events were observed during hospitalization or follow-up. Discussion: The observed clinical response suggests that scalp acupuncture may have a potential adjunctive role in pediatric HE. Plausible mechanisms include autonomic modulation, attenuation of sympathetic activity, improvement of cerebral blood flow and vascular reactivity, modulation of nitric oxide-related pathways, and neuroprotective or anti-inflammatory effects. Conclusions: The application of scalp acupuncture for pediatric HE may be a promising therapeutic adjuvant in controlling blood pressure. Nevertheless, causality cannot be established from a single case, particularly given concurrent antihypertensive therapy and dialysis-based volume management. Further studies are needed to evaluate its efficacy and safety in this setting.