Journal of Pediatric Neurology 2022; 20(02): 109-112
DOI: 10.1055/s-0041-1730920
Case Report

Facial Neuritis as a Manifestation of Gradenigo's Syndrome

1   Division of Neurology, Department of Paediatrics, College of Medicine, King Saud University, King Saud University Medical City, Riyadh, Saudi Arabia
Osama Y. Kentab
2   Emergency Department, King Abdullah Bin Abdulaziz University Hospital, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
› Author Affiliations


Gradenigo's syndrome (GS) is a rare, acquired syndrome caused by middle ear infections or mastoiditis. It is identified by the triad of otorrhea due to otitis media (OM), retro-orbital pain in the region innervated by the first and second divisions of the trigeminal nerve, and diplopia as a result of cranial nerve (CN) VI palsy. As a result of extension of the inflammation, the facial nerve (VII) may also be affected. GS has a poor prognosis unless promptly diagnosed and treated. Herein, we report the clinical and radiological findings observed in two children diagnosed with chronic suppurative OM, mastoiditis, and facial neuritis. Both were medically managed as cases of GS with high-dose intravenous antibiotic and full recovery was achieved a few weeks after discharge. There was no need for any surgical intervention. This case report illustrates the importance of early recognition, diagnosis, and treatment of this treatable syndrome using antibiotics to prevent subsequent fatal complications and further need for surgical intervention.


Written informed consent for the publication of this case report was obtained from the parents of the patients.

Authors' Contributions

A.Y.K. managed the patients and wrote the manuscript as the main author. O.Y.K. share in patient's management, critically reviewed, and helped organize the manuscript. All authors read and approved the final manuscript.

Publication History

Received: 12 February 2021

Accepted: 25 March 2021

Article published online:
19 June 2021

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