Paget's disease of the skull has several different neurological complications including headache, deafness, optic atrophy, basilar invagination with compression of the hind brain, and hydrocephalus with dementia. Two cases illustrate the association of grand mal epilepsy with two types of Paget's disease of the skull: osteoporosis circumscripta and generalised thickening of the bone. It might be argued that the association is coincidental, as both are common diseases. in case 1, however, the focal features of the attack, together with focal abnormalities on the EEG at the site of the bony defect and the increased uptake on the gamma scan there, suggest the association is more than fortuitous. In case 2 the bony abnormality was generalised, but the relatively young age of the patient and late onset of the epilepsy suggest that the conditions are related.
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