Open AccessTolosa-Hunt Syndrome: A Case Report
Author(s) -
K C Siddhanta,
K C Shreeyanta,
Prajjwal Kunwar,
Krishna Dhungana
Publication year - 2021
Publication title -
journal of nepal medical association
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.176
H-Index - 19
eISSN - 1815-672X
pISSN - 0028-2715
DOI - 10.31729/jnma.5700
Subject(s) - tolosa–hunt syndrome , medicine , ptosis , hypoesthesia , cavernous sinus , superior orbital fissure , magnetic resonance imaging , diplopia , surgery , trochlear nerve , sixth nerve palsy , abducens nerve , palsy , oculomotor nerve , orbit (dynamics) , radiology , pathology , alternative medicine , engineering , aerospace engineering
Tolosa-Hunt Syndrome is a rare disease characterized by painful ophthalmoplegia affecting third, fourth, and/or sixth cranial nerve caused by non-specific inflammation in the cavernous sinus or superior orbital fissure of unknown etiology. We presented a 67-year-old female with Tolosa-Hunt Syndrome. She had a right-sided headache and periorbital pain with double vision. Examination showed right-sided ptosis, right-sided trochlear and abducens nerve palsy, and partial right-sided oculomotor nerve palsy with hypoesthesia in the area of the ophthalmic division of the trigeminal nerve. Magnetic resonance imaging of head and orbit showed altered signal intensity changes in the optic nerve and lateral rectus muscle. After steroid therapy, pain and ptosis were significantly improved in 72 hours. Tolosa-Hunt Syndrome is a diagnosis of exclusion, with clinical presentation, normal investigations, magnetic resonance imaging findings, and response to steroid therapy crucial in making the diagnosis.