Md. Nazrul Islam1, Mrinal Kanti Das2, Mushahid Thakur3, Md. Mashukur Rahman4
1. Associate Professor, Department of Neurology, North East Medical College & Hospital, Sylhet
2. Professor, Department of Medicine, North East Medical College & Hospital, Sylhet.
3. Colonel & Professor, Department of Ophthalmology, Ragib Rabeya Medical College & Hospital, Sylbet.
4. Professor, Department of ENT, North East Medical College & Hospital, Sylhet.
Abstract
Gradenigo’s syndrome (GS), a rare complication of otitis media, consists of suppurative otitis, abducens nerve palsy and pain in the trigeminal nerve area. Most casex are caused by medial extension of acute otitis media into a pneumatized petrous apex and surgical drainage is usually the treatment of choice. A 50-year-old man who presented with the history of left-sided headache, earache, tingling and numbness in the left side of face and diplopia. Examination demonstrated a left eye lateral gaze palsy and diplopia. Otoscopy revealed no effusion in the tympanic space. Tympanic membrane was found retracted and dull but no perforation with a congested tympanic membrane. A magnetic resonance imaging study showed left sided otomastoiditis, feature of meningitis, left temporo-parieto-occipital cerebritis consistent with Gradenigo’s syndrome. Present case highlighting elderly onset chronic form and successful conservative treatment instead of surgical treatment.
Key Words: Gradenigo’s syndrome, otitis media, diplopia, otomastoiditis