Abstract
Gradenigo syndrome is a relatively rare complication of otitis media characterized by trigeminal neuralgia and paralysis of the 6th cranial nerve. This report presents a case of Gradenigo syndrome associated with pregnancy. A 41-year-old pregnant female experienced left ear discharge following acute otitis media for 2 months, but received no pertinent antibiotics. She suddenly felt severe pain in her left temporal region in addition to diplopia. An urgent CT scan revealed poorly pneumatized cells in the left petrous apex, and MR showed suspicious inflammation extending to the apex from the middle ear. She was diagnosed with Gradenigo syndrome, and was treated by 300 mg CFPN-PI orally for 12 days. The temporal ache quickly diminished, so no further treatment was administered. The 6th cranial nerve paralysis recovered completely after 3 months. A follow-up CT was scanned after normal delivery, but showed yet no pneumatization in the apex. This suggests that the 5th and 6th cranial nerve disorders were probably induced by dural edema in the petrous apex even without the formation of an abscess. The present case emphasizes the clinical significance of this classic syndrome, and the appropriate use of antibiotics is essential even in the case of a pregnant female.
