Skull Base Osteomyelitis Presenting with Facial Paralysis, Low Cranial Nerve Palsies and Bilateral Carotid Involvement: A Case Report

Murat Mert Atmaca, Nilüfer Yeşilot Barlas, Oğuzhan Çoban

İstanbul University Faculty of Medicine, Department of Neurology, İstanbul, Turkey

Keywords: Skull base osteomyelitis, external otitis, pseudomonas aeruginosa, internal carotid artery

Abstract

Skull base osteomyelitis (SBO) typically presents with severe otalgia and unilateral otorrhea in immune-compromised, particularly in elderly diabetic patients. Skull base osteomyelitis usually presents with external otitis but it can also occur as a complication of acute otitis media and mastoiditis. Complications of SBO are venous sinus thrombosis, meningitis, abscess, cranial neuropathies and carotid invasion with or without ischemic stroke. Here we report a case with SBO presenting with facial paralysis, lower cranial nerve palsies and bilateral carotid involvement which occurred following sore throat and bilateral otalgia.