Not everything is mastoiditis. Gradenigo syndrome as intracranial complication of acute otitis media in pediatric age
Resonancia magnética de cráneo ponderada en T2 en la que se observa alteración en la señal del ápex petroso izquierdo
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Keywords

Abducens Nerve
Trigeminal Nerve
Otitis Media
Petrositis

How to Cite

1.
Iglesias Rodríguez M, Navarro Abia V, Gil Calderón F, Conejo Moreno D. Not everything is mastoiditis. Gradenigo syndrome as intracranial complication of acute otitis media in pediatric age. Bol Pediatr. 2025;64(270):286-288. Accessed February 5, 2025. https://boletindepediatria.org/boletin/article/view/1882

Abstract

Background. Otitis media is a common disease in pediatric patients. It is usually a benign process, allowing for symptomatic treatment  and observation in patients without risk factors. However, potentially severe complications are not uncommon, with mastoiditis being the most frequent one.

Clinical case. We present the case of a 9-year-old female patient, with a medical history of multiple otitis media, who developed petrositis, also known as Gradenigo syndrome, as a complication of one of her episodes. She presented acute diplopia and headache when she was admitted to the Emergency Department. After diagnostic confirmation via magnetic resonance, she received intravenous antibiotics with clinical resolution and normalization of ancillary tests in follow-up visits.

Conclusions. The presence of focal neurological deficit of either abducens or trigeminal nerve in a patient with a history of otitis media or with concurrent otitis media, should arise the concern about the presence of Gradenigo syndrome. In our patient, the quick identification and prompt antibiotic treatment allowed a quick recovery without need for mastoidectomy.

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