Concomitant occurrence of fibrous dysplasia and epilepsy: Report of an unusual case

Abstract

Background: Fibrous dysplasia (FD) is a developmental anomaly in which normal bone is gradually replaced with fibrous connective tissue. There are two variants: monostotic and polyostotic. The diagnosis of fibrous dysplasia is generally made on the basis of clinical and radiographic findings. The association between epilepsy and craniofacial fibrous dysplasia is rather unusual. A case of fibrous dysplasia is presented here which was seen co-existing with epileptic seizures. Case Presentation: An 18-year-old male patient reported to the department with the chief complaint of a painless swelling on the right side of the face since 4 years. He gave history of trauma secondary to a fall 4 years back and seizures since 2 years. On extra-oral examination, a diffuse swelling was seen on the right middle third of face extending medio-laterally from ala of nose to outer canthal line, superiorly involving the zygomatic arch. The swelling was bony hard and non-tender on palpation. Intra-orally, swelling was seen associated with right buccal vestibule extending from right lateral incisors to second molar region, with normal overlying surface. Based on the history and clinical presentation a provisional diagnosis of a benign lesion was made. Radiographic features were suggestive of a fibro-osseous lesion, most probably fibrous dysplasia. Considering the fact that fibrous dysplasia may sometimes lead to epilepsy, patient was referred for thorough neurological examination. A surgery was then planned for the patient for correction of the facial deformity. However, the patient refused any further treatment. Conclusion: A clinician must be vigilant and cognizant of this association so that a prompt referral and treatment may be achieved.