[Frontal sinus pathology and epilepsy].
OBJECTIVE
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.


CONCLUSIONS
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.
Duvillard
C
C
Service d'otorhinolaryngologie, de chirurgie cervicofaciale et de phoniatrie, hôpital Général, 3 rue du Faubourg-Raines, BP 1519, 21033 Dijon cedex, France. christian.duvillard@chu-dijon.fr
Gazzano
E
E
Lecomte
H
H
Romanet
P
P
D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001921:Brain / Q000000981:diagnostic imaging / Q000503:physiopathology; D002781:Cholesteatoma / Q000209:etiology / Q000473:pathology; D004359:Drug Therapy, Combination; D004388:Dura Mater / Q000473:pathology; D004569:Electroencephalography; D004829:Epilepsy, Generalized / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D015522:Frontal Sinusitis / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D010254:Paranasal Sinus Diseases / Q000209:etiology / Q000473:pathology; D011241:Prednisone / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed
D000900:Anti-Bacterial Agents; D000893:Anti-Inflammatory Agents; D011241:Prednisone