A previously well 10-year-old indigenous girl presented with generalized tonic-clonic seizures secondary to hypertensive encephalopathy. Measured blood pressure was 180/135 mmHg and brain magnetic resonance imaging confirmed changes consistent with posterior reversible encephalopathy syndrome. Persistent severe headaches and frequent vomiting were reported for 2 weeks before presentation. Mild hypertension (systolic blood pressure 135 mmHg) was documented during a hospital admission for management of a fractured radius/ulna 3 months prior.