Skull base osteomyelitis (SBO) arising from the sphenoidal paranasal air sinus infection without associated external otitis is rare. Initially SBO may have headache as the only symptom with cranial neuropathies occurring later. We report a 10-year-old immunocompetent girl with headache and chronic sinusitis, who developed a lateral medullary syndrome following streptococcal milleri sphenoidal osteomyelitis.
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