Gradenigo's syndrome is a rare but life threatening complication of acute otitis 
media (AOM), which includes a classic triad of otitis media, deep facial pain 
and ipsilateral abducens nerve paralysis. The incidence of Fusobacterium 
necrophorum infections has increased in recent years. We describe two cases of 
Gradenigo's syndrome caused by F. necrophorum. Additional four cases were 
identified in a review of the literature. Gradenigo's syndrome as well as other 
neurologic complications should be considered in cases of complicated acute 
otitis media. F. necrophorum should be empirically treated while awaiting 
culture results.