Background: Intracranial aneurysms are the most common vascular cause of painful ophthalmoplegia. Symptoms include retro-orbital pain, diplopia, ophthalmoplegia, trigeminal neuropathy, or a combination of these. Most single aneurysms cause ipsilateral, painful ophthalmoplegia. Here, we report the first, to our knowledge, case of bilateral painful ophthalmoplegia possibly caused by an aneurysm of the cavernous segment of the left internal carotid artery.
Case Presentation: A 62-year-old male patient presented with headache and bilateral ptosis. Laboratory tests revealed hypopituitary function. Computerized tomography angiography showed a large aneurysm in the cavernous sinus segment of the left internal carotid artery. Aneurysm embolization was performed in the Nerve Interventional Department. Four months after surgery, the patient's symptoms returned to normal.
Conclusions: This case suggests that patients with bilateral painful ophthalmoplegia should be screened for aneurysms using computed tomography angiography or magnetic resonance angiography immediately.
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http://dx.doi.org/10.1186/s12883-023-03066-0 | DOI Listing |
J Pak Med Assoc
January 2025
Department of Ophthalmology and Visual Sciences, Dow University of Health Sciences, Karachi, Pakistan.
Tolosa-Hunt Syndrome (THS) is an exceptionally rare disorder characterised by recurrent episodes of excruciating ophthalmoplegia, commonly affecting one side of the face and involving the third, fourth, sixth, and fifth cranial nerves. This syndrome results from non-specific inflammation affecting the cavernous sinus, superior orbital fissure (SOF), and/or orbital apex. In this case report, we present the clinical features, diagnostic evaluation, and management of a 46-year-old female with THS.
View Article and Find Full Text PDFCureus
December 2024
Neurology and Neuroscience, Medical University of Varna, Varna, BGR.
Neuromyelitis optica spectrum disorder (NMOSD) includes conditions with autoimmune genesis, which are manifested by attacks of optic neuritis (ON) and transverse myelitis (TM), and also express aquaporin 4 (NMO-IgG) or myelin oligo-endocytic glycoprotein (MOGAb) antibodies. In rare cases, the disease may also have a clinical presentation with only TM, without ON or with ON, without TM. These conditions are also included in the spectrum.
View Article and Find Full Text PDFZhonghua Yan Ke Za Zhi
January 2025
Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin300052, China.
Front Immunol
January 2025
Department of Neurology, Chengdu Second People's Hospital, Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan, China.
Anti-GQ1b antibody syndrome is a spectrum of autoimmune disorders affecting nervous systems. We report a case of a 53-year-old woman presenting mydriasis with acute onset of periorbital pain, photophobia, and subsequently, diplopia. Despite weakly positive anti-GQ1b IgG antibody, the patient exhibited atypical features with isolated ophthalmoplegia and absence of classic Miller-Fisher syndrome triad.
View Article and Find Full Text PDFMed J Armed Forces India
December 2024
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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