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Gradenigo Syndrome in a Human Immunodeficiency Virus-Positive Patient

Cesar Morales, MD; Allan Tachauer, MD
Arch Intern Med. 1997;157(18):2149. doi:10.1001/archinte.1997.00440390153018.
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Gradenigo syndrome, first described in 1907, consists of a clinical triad of otitis media, facial pain, and abducens paralysis. Subsequent work located the site of the lesion at the apex of the petrous bone; it is here that the cranial nerves V and VI are anatomically in close proximity, being separated from the petrous bone only by dura mater. Causes include inflammation of the petrous bone, usually secondary to infection of the mastoid and middle ear, and, rarely, bone tumor, traumatic aneurysm cholesteatoma, and T-cell lymphoma.

Report of a Case.  An otherwise-healthy, 44-year-old man was admitted to the hospital with a 1-week history of rightsided facial pain and diplopia. His medical history was significant for surgery on his right ear 3 months before admission and dental work on a right upper molar 2 weeks before admission. His social and sexual history was noncontributory. Physical examination revealed a wellnourished, febrile (38°C)


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