Potts Puffy Tumor: A Rare Cause of Seizure in Children

Year 2021, Volume: 4 Issue: 3, 99 - 102, 25.12.2021

Roshan Verma Sajith Abraham

Abstract

Potts puffy tumor is subperiosteal abscess of the frontal bone associated with frontal osteomyelitis. It can present with seizures as the presenting feature. We report a case of 14-year-old male who presented with seizures secondary to Potts puffy tumor. A 14-year-old adolescent male presented with complaints of recurring episodes of generalized tonic clonic seizure. On examination, he was also found to have swelling over the forehead. He also complained of intermittent high-grade fever, nasal obstruction, and headache. Laboratory investigation showed leukocytosis. Contrast-enhanced magnetic resonance imaging of brain showed the presence of left frontal swelling with subcutaneous collection, frontal bone defects with bifrontal chronic subdural collection, and underlying buckling of brain parenchyma. Contrast-enhanced computed tomographic scan of paranasal sinuses showed the presence of fluid collection over the frontal region, with enhancing anterior frontal wall thickening, with another extra-axial fluid collection just beneath the inner table of frontal bone with associated erosion and cortical irregularity in the adjacent frontal bone. Endoscopic sinus surgery with external drainage of Pott’s puffy tumor was done. Intravenous antibiotic was given for 6 weeks along with antiepileptics. Potts puffy tumor is a rare complication of frontal sinusitis, which can present rarely to emergency with seizures and frontal swelling.

Keywords

Potts puffy tumor , frontal osteomyelitis , seizures , forehead swelling

References

• Flamm ES. Percivall pott: An 18th century neurosurgeon. J Neurosurg. 1992;76(2):319-326.
• Verma RK, Behera S. Endoscopic management of Pott’s puffy tumor-still a common entity in-developing country a case series of three patients: Our experience. Int J Pediatric Otorhinolaryngol Extra. 2018;19:10-13.
• Sade R, Polat G, Kantarci M. Unusual cause of seizure. J Craniofac Surg. 2016;27:E548-E549.
• Costa L, Mendes Leal L, Vales F, Santos M. Pott’s puffy tumor: Rare complication of sinusitis. Braz J Otorhinolaryngol. 2020;86(6):812-814.
• Brook I, Friedman EM, Rodriguez WJ, et al. Complications of sinusitis in children. Pediatrics. 1980;66(4):568-572.
• Kombogiorgas D, Solanki GA. The Pott puffy tumor revisited: Neurosurgical implications of this unforgotten entity. Case report and review of the literature. J Neurosurg. 2006;105(2):143-149.
• Pender ES. Pott’s puffy tumor: A complication of frontal sinusitis. Pediatr Emerg Care. 1990;6:280-284.
• Tsai BY, Lin KL, Lin TY, et al. Pott’s puffy tumor in children. Childs Nerv Syst. 2010;26:53-60.
• Giannoni CM, Stewart MG, Alford EL. Intra cranial complications of sinusitis. Laryngoscope. 1997;107:863-867.
• Durur-Subasi I, Kantarci M, Karakaya A, Orbak Z, Ogul H, Alp H. Pott’s puffy tumor: Multidetector computed tomography findings. J Craniofac Surg. 2008;19:1697-1699.
• El-Silimy O. Combined endonasal and percutaneous endoscopic approach to Pott’s puffy tumour. Rhinology. 1996;34:119-122.
• Brook I. Microbiology and antimicrobial treatment of orbital and intracranial complications of sinusitis in children and their management. Int J Pediatr Otorhinolaryngol. 2009;73:1183-1186.
• Lang EE, Curran AJ, Patil N, Walsh RM, Rawluk D, Walsh MA. Intracranial complications of acute frontal sinusitis. Clin Otolaryngol Allied Sci. 2001;26:452-454.