Gradenigo's Syndrome Without Facial Nerve Involvement in a Fourteen-Month-Old Girl

Gradenigo’s syndrome consists of ophthalmoplegia, facial palsy, and facial pain due to involvement of abducens and facial nerves as well as the trigeminal ganglion. This involvement is due to infections of ipsilateral middle ear and mastoid bone.. A 14-month-old girl was referred to a private clinic with chief complaint of acute and sudden-onset right ophthalmoplegia. There was a history of upper respiratory tract infection and subsequent otitis media one week ago. Right mastoiditis was seen in brain MRI.. The presence of facial palsy and facial pain is usual in Gradenigo’s syndrome; however, in this case, the only sign was abducens nerve palsy and subsequent ophthalmoplegia, which is very rare and unusual presentation of this syndrome..