Gradenigo's syndrome presenting as IX and X cranial nerve palsy without clinically apparent ear infection: A case report and review of literature

• DOI: 10.1016/j.ensci.2022.100397
• Publication Date: 2022-03-17T14:32:54Z
• Authors: Safia Bano; Ahmad Nawaz; Abyaz Asmar; Muhammad Aemaz Ur...; Hareem Farooq; Hamid Ali
• Keywords: Abducens nerve; Trigeminal Nerve; Oculomotor nerve palsy

Gradenigo's syndrome (GS) is a triad (otorrhea, abducens nerve palsy, and pain in the trigeminal distribution) of clinical findings that are caused by contiguous spread petrous apicitis to nearby neurovascular structures. Petrous usually secondary otitis media but atypical etiologies absence classical pose diagnostic challenge for physicians. We report rare case GS an afebrile 55-year-old male who presented with unilateral headache, dysphagia hoarseness (IX X cranial involvement), diplopia lateral gaze palsy (VI involvement) neuralgia or history media. Magnetic Resonance Imaging (MRI) revealed hyperintense lesions right apex indicating apicitis, hallmark GS. Prompt initiation broad-spectrum antibiotics led marked improvement voice quality on 4th post-admission day, complete resolution symptoms end fourth week. This shows can present even clinically apparent ear infection palsies may not be limited V VI all cases. Physicians should aware such manifestations as prompt radiological assessment followed early prevent life-threatening complications from developing.