Tolosa-Hunt syndrome (THS) is an extremely rare disorder characterized by painful unilateral ophthalmoplegia triggered by idiopathic inflammation of the cavernous sinus affecting the third, fourth, and/or sixth cranial nerve. Corticosteroid therapy effectively improves THS symptoms; thus, early clinical suspicion and diagnosis are essential. We report the case of a 37-year-old patient who presented with left-sided eye pain and double vision for four days. Physical examination was significant for oculomotor, trochlear and abducent nerves palsies on the left eye with slow light reflex. Contrast-enhanced magnetic resonance imaging of the head displayed mild asymmetry of the cavernous sinus regions with fullness on the left side and focal lateral thickening, confirming the THS diagnosis. The patient's symptoms improved dramatically upon starting oral corticosteroid therapy.
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| http://dx.doi.org/10.7759/cureus.26093 | DOI Listing |
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Tolosa-Hunt syndrome in children and adolescents: A systematic review.
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January 2025
Bangalore Medical College and Research Institute, Bangalore, India.
Objective: This systematic review aims to consolidate and analyze the existing evidence on Tolosa-Hunt syndrome (THS) in the pediatric population, focusing on clinical features, diagnostic challenges, treatment outcomes, and prognosis.
Background: Tolosa-Hunt syndrome is a rare headache disorder caused by idiopathic inflammation of the cavernous sinus, orbital apex, or orbit, resulting in neuro-ophthalmological manifestations. It is uniquely characterized by cranial nerve palsies and often responds well to steroids.
[Clinical analysis of Tolosa-Hunt syndrome].
Zhonghua Yan Ke Za Zhi
January 2025
Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin300052, China.
Article Synopsis
- The study analyzed clinical features of Tolosa-Hunt syndrome (THS), a type of painful ophthalmoplegia, by collecting data from patients diagnosed at a hospital over four years.
- A total of 35 patients were included, with 18 diagnosed with THS, who typically presented symptoms like pain, ptosis, and MRI abnormalities, alongside various immunological findings.
- Treated with glucocorticoids, most THS patients saw symptom relief within weeks, though some experienced relapses during follow-up.
Tolosa Hunt syndrome: A rare cause of headache.
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INHS Kalyani, Visakhapatnam, India.
Tolosa Hunt syndrome (THS) is characterized by painful ophthalmoplegia preceded by retro orbital headache. First described in year 1952, it is a diagnosis of exclusion and is extremely rare entity Here we present a case report of syndrome in a female patient who presented with 03 weeks of progressive unilateral retro orbital headache followed by acute onset ptosis and complete ophthalmoplegia in right eye. On evaluation (brain imaging) and after ruling out all the other differentials, she was diagnosed as a case of THS.
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