Neurological symptoms derived from isolated sphenoid sinusitis in children: a report of 3 patients

Abstract

Inflammation of the sphenoid sinus is rare, and usually occurs in conjunction with other paranasal sinus infections. Isolated sphenoiditis is even rarer and is reported almost uniquely in children older than 6 years. It is frequently misdiagnosed, because of its rarity and its varied and atypical symptoms, but it may induce serious – even fatal complications, due to the involvement of many intracranial structures. We report 3 cases of isolated sphenoiditis in previously healthy children, with various symptoms indicating acute central nervous system (CNS) disorder: A 4 year old boy with sommolence and meningitis-like symptoms, an 11 year old boy with visual illusions and a 12 year old boy with headache, emesis and positive Romberg’s sign. In the initial clinical estimation there was no strong suspicion of infection, except in the 1st patient, because of the atypical symptoms. Diagnosis was established by a head CT scan, and all patients were treated with intravenous clindamycin plus cephalosporine, plus one dose methylprednisolone. The outcome was good.