The advent of palsy of the sixth nerve, parietotemporal or supraorbital pain occurring in connection with an acute suppurative otitis media has long been a well established clinical entity. According to the clinical manifestations, three groups of cases are described:
The first group includes patients who have an acute otitic infection, parietotemporal, supra-orbital or retrobulbar pain and a paresis of the sixth nerve. The majority of these patients recover spontaneously.
The second group includes patients who present all of the conditions mentioned, and in addition have involvement of the second, third and fourth nerves. Most of these patients recover.
The third group includes patients who present the symptoms of either of the previous groups, but in whom the condition has a fatal termination as a result of a diffuse leptomeningitis.
The pathologic process of the so-called Gradenigo's syndrome exists in the form of a circumscribed serous leptomeningitis, which originates
GREENFIELD SD. GRADENIGO'S SYNDROME. Arch Otolaryngol. 1929;9(2):171–174. doi:10.1001/archotol.1929.00620030185005
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