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The long-term evolution to intractable epilepsy in children treated with cyclosporine administered for graft-versus-host-disease after hematopoietic stem cell transplantation was evaluated. In a group of 185 children treated with cyclosporine after bone marrow transplantation, 15 (8%) presented with acute seizures that were generalized in 7 and focal in 7 and had absence status in 1. Electroencephalography (EEG) and neuroimaging showed predominant abnormalities in the occipital regions. One patient died shortly after the seizure; in seven cases, seizures remitted, whereas relapses were observed in seven others. After the first year, seizures persisted chronically in four cases and evolved to intractable epilepsy. Focal temporal epilepsy was diagnosed in three cases, whereas in the fourth case, a multifocal epilepsy was observed. Magnetic resonance imaging (MRI) detected mesial temporal sclerosis in all of these cases. The risk factors associated with evolution to epilepsy included lower age at transplantation (3—5 years), more than one relapsing seizure in the first year after transplantation, and longer treatment with cyclosporine. Not only can cyclosporine cause acute central nervous system toxicity, it can also determine intractable epilepsy associated with mesial temporal sclerosis. (J Child Neurol 2006;21:861—866; DOI 10.2310/7010.2006.00196).

Summary Fibrous dysplasia is a rare, benign disease even though clinical picture may assume severe aspects. It presents a progressive replacement of normal bone structures by fibrous tissue which can involve one or more bone segments and, in some cases, it could be associated with skin lesions and endocrinopathies (McCune–Albright syndrome). It manifests clinically with dysmorphic syndrome, ophtalmologic or otologic signs. Vertigo in an uncommon presentation symptom. We report a case of monostotic fibrous dysplasia of the temporal bone presenting as dizziness in an 11-year-old boy and review the scientific literature.