[Frontal sinus pathology and epilepsy].

Abstract

OBJECTIVES:

Because of its location and the fragility of its physiology, the frontal sinus is the first of the facial sinuses to cause complications. In this context, orbital sepsis, cranial vault osteitis, meningitis, cerebral abscess, longitudinal sinus thrombophlebitis can occur. A more uncommon consequence of frontal sinusitis is isolated epilepsy.

METHODS:

We report two cases of patients admitted in our department after a generalised epilepsy seizure with, on the CT-scan, an opacity of the frontal sinus with a posterior wall lysis.

RESULTS:

We operated on quickly both patients after the seizure via an eyebrow approach. The first one had a purulent collection of the frontal sinus, the second an infected cholesteatoma. Both had a stenosis of the nasofrontal canal and a lysis of the sinus posterior wall with a bare dura mater. The surgical treatment consisted in the cleaning of the sinus associated with an antibiotic treatment in one case and the cholesteatoma matrix removal in the other. The nasofrontal canal was calibrated for respectively four and two months. An antiepileptic treatment was administered for one year. Four years later the nasofrontal canal is pervious and the frontal sinus sound in both patients.

CONCLUSION:

An epilepsy seizure can follow a frontal sinusitis. It does not convey the existence of an endocranial complication but requires researching it. The posterior wall lysis of the sinus with a bare dura mater is sufficient to lead to a seizure in case of sinus infection.

• Authors: C Duvillard, E Gazzano, H Lecomte, P Romanet
• Journal: Annales d'oto-laryngologie et de chirurgie cervico faciale : bulletin de la Societe d'oto-laryngologie des hopitaux de Paris (Ann Otolaryngol Chir Cervicofac) Vol. 124 Issue 3 Pg. 126-30 (Jul 2007) ISSN: 0003-438X [Print] France
• Vernacular Title: Epilepsie et pathologie du sinus frontal.
• PMID: 17475201 (Publication Type: Case Reports, Journal Article)

Chemical References

• Anti-Bacterial Agents
• Anti-Inflammatory Agents
• Prednisone

Topics

• Adult
• Anti-Bacterial Agents (therapeutic use)
• Anti-Inflammatory Agents (therapeutic use)
• Brain (diagnostic imaging, physiopathology)
• Cholesteatoma (etiology, pathology)
• Drug Therapy, Combination
• Dura Mater (pathology)
• Electroencephalography
• Epilepsy, Generalized (diagnosis, etiology, physiopathology)
• Frontal Sinusitis (complications, diagnostic imaging, drug therapy)
• Humans
• Male
• Middle Aged
• Paranasal Sinus Diseases (etiology, pathology)
• Prednisone (therapeutic use)
• Tomography, X-Ray Computed