Clinical Picture

Sturge-Weber angiomatosis
Atul P Sattur, Megha Goyal
Lancet 2011; 378: 1580 Published Online September 9, 2011 DOI:10.1016/S01406736(11)60249-3 Department of Oral Medicine and Radiography, SDM College of Dental Sciences and Hospital, Dharwad 580009, Karnataka, India (A P Sattur MDS, M Goyal MDS) Correspondence to: Dr Atul P Sattur, Department of Oral Medicine and Radiography, SDM College of Dental Sciences and Hospital, Dharwad 580009, Karnataka, India dratulomr@yahoo.com

A 20-year-old woman presented with a 1-month history of swollen gums. Her medical history included seizures for the past 19 years and a macular patch on the right side of her face since birth. She was taking phenytoin for her seizures. Intraoral examination showed extension of the macular patch on the right side of the oral cavity and generalised gingival enlargement. On the basis of her history and clinical presentation she was diagnosed with Sturge-Weber angiomatosis and drug-induced gingival enlargement. Extraoral skull
A B

radiographs showed tramline calcication because of angiomas aecting the leptomeninges. The patient was given meticulous oral treatment and her antiepileptic medication was changed. The angiomas present in our patient are malformations of blood vessels in the pia mater causing the calcication and loss of nerve cells in the cerebral cortex. These sequelae of the malformations give rise to the clinical symptom of seizures and radiological sign of tramline calcication.

Figure: Sturge-Weber angiomatosis (A) Gingival enlargement and radiographs showing tram-line calcication (B and C).

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