My 4 year old daughter ran a fever (102-103) for approximately 6 days and complained of a headache (usually pointing to her forehead). She also had swelling between her eyes and on the lower part of her forehead. X-rays were done and a sinus infection was detected in her left maxillary sinus. I was told her frontal sinuses were not developed yet. She was put on Augmentin and complained of the headache and fever for 2 more days. Five days after the X-rays she had a status seizure. Due to the medication she was given to stop the seizure she was intubated. After many tests CT scan, MRI and EEG a clot was found on the front/top of her head. Most of the neurologists reading the films agreed it was an old head trauma and it should resolve on its own. It may have nothing to do with the seizure. An ENT and one neurologist have mentioned inflammation of the ethmoid lining as a possible cause? Could you provide any information on this: what it is? how it is caused? and could there be a link to the collection that was found on the top of her head? My daughter had swelling between her eyes and on her forehead about 2 weeks after she was in the hospital but her sinuses looked clear and she was not complaining of any headaches or running a fever at that time. The swelling went down in about 48 hours. She is present taking Tegretol twice a day (250 mg/day). Any information you could provide would be greatly appreciated. Thank you.
Reply: -----------------------------
There are potential central nervous system complications that can occur with sinusitis in children or adults. One potential complication is epidural abscess. Others include brain abscess or meningitis. Such central nervous complications of sinusitis can occur via spread of infection through blood vessels or by direct extension through certain channels in the bone that separates the sinuses from the brain. The symptoms of such complications would include fever and neurological symptoms such as headache, stiff neck, lethargy, visual disturbance, personality change, seizure, etc. combined with the common symptoms of sinusitis - nasal congestion, post-nasal drainage, nasal discharge, sore throat, etc. CT scans or preferably MRI scans would generally reveal diagnostic findings. Fortunately, the advent of antibiotic therapy has resulted in such complications of sinusitis being infrequent.
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Steve Dankle, MD
Otolaryngology-Head and Neck Surgery
Milwaukee, Wis
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