Focal Electroencephalography Rhythm Asymmetry due to Focal Skull Fibrous Dysplasia

An unusual pervasive and persistent asymmetry in background rhythm was found on surface electroencephalography (EEG) recordings in a 22 year old with new onset of generalized seizure activity. Radiographic correlation with computed tomography, positron emission tomography and bone scan imaging uncovered that the higher amplitude left frontal-parietal background activity was related to a circumscribed area of left frontal-parietal fibrous dysplasia affecting the skull. This case report emphasizes that the presumed higher electrical conductance of fibrous dysplasia lead to a greater transparency of normal background rhythms, and must be taken into account as a form of breach rhythm for accurate EEG interpretation.