Diagnosis and Treatment of Tolosa-Hunt Syndrome in the Emergency Department

Olsen, Kevin; Johnson, Andrew P.; Castillo-Jorge, Sarah; Bennett, Jeffrey V.; Ryan, Matthew F.

doi:10.4236/ojem.2017.51001

Cited by 2 publications

(12 citation statements)

References 6 publications

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“…11 Tumor Tumor di daerah sellar, pembesarannya sering menekan saraf optik dan saraf di dalam sinus kavernosus, termasuk saraf okulomotor, saraf troklear, saraf abducens, dan cabang pertama saraf trigeminal. 7,8 Trauma Kelumpuhan saraf okulomotor dapat disebabkan oleh trauma. Disfungsi saraf dapat disebabkan oleh fraktur orbital atau pembengkakan jaringan lunak yang rusak.…”

Section: Cedera Iskemikunclassified

“…Oftalmoplegia menyebabkan posisi khas bola mata karena kelumpuhan otot rektus medialis, rektus superior, rektus inferior, dan oblik inferior. 8 Papiledema dapat ditemukan pada sindrom Tolosa Hunt dengan inflamasi apeks orbital yang mengakibatkan obstruksi aliran vena dan kerusakan saraf optikus. Keluhan penurunan tajam penglihatan dapat bervariasi dan dapat permanen.…”

Section: Diagnosisunclassified

“…Keluhan penurunan tajam penglihatan dapat bervariasi dan dapat permanen. 7,8 Diagnosis banding penyakit ini adalah infeksi, selulitis orbital, trombosis sinus kavernosus, neoplasma, anomali vaskular, dan penyakit autoimun. 8 Trombosis sinus kavernosus dapat terjadi akibat infeksi septik atau nonseptik.…”

Section: Diagnosisunclassified

“…7,8 Diagnosis banding penyakit ini adalah infeksi, selulitis orbital, trombosis sinus kavernosus, neoplasma, anomali vaskular, dan penyakit autoimun. 8 Trombosis sinus kavernosus dapat terjadi akibat infeksi septik atau nonseptik. Untuk kasus septik, sekitar 80% sampai 100% dengan onset akut demam, proptosis, kemosis, ptosis, dan kelumpuhan saraf kranial III, IV, dan/atau VI.…”

Section: Diagnosisunclassified

“…Untuk kasus septik, sekitar 80% sampai 100% dengan onset akut demam, proptosis, kemosis, ptosis, dan kelumpuhan saraf kranial III, IV, dan/atau VI. 8 Pada 50% hingga 80% kasus terdapat edema periorbital, nyeri kepala, lesu, refleks pupil menurun, edema diskus optikus, dan pelebaran vena retina sentralis. Pembentukan bekuan darah di dalam sinus kavernosus sering terjadi akibat penyebaran infeksi bakteri gram positif.…”

Section: Diagnosisunclassified

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Diagnosis dan Tata Laksana Sindrom Tolosa Hunt

Suhendro

2023

Cermin Dunia Kedokteran

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Sindrom Tolosa Hunt adalah nyeri periorbital atau orbital unilateral serta paresis satu atau lebih saraf kranial III, IV, dan/atau VI, yang disebabkan oleh peradangan sinus kavernosus, fisura orbital superior, dan rongga orbital. Gejala berkurang dalam 72 jam setelah terapi corticosteroid yang adekuat. Diagnosis yang tepat memungkinkan intervensi segera, dengan demikian dapat mencegah keparahan termasuk kehilangan penglihatan. Tolosa Hunt syndrome is unilateral periorbital or orbital pain and paresis of one or more cranial nerves III, IV, and/or VI caused by inflammation of the cavernous sinus, superior orbital fissure, and orbital cavity. Symptoms will relieve within 72 hours after adequate corticosteroid therapy. Appropriate diagnosis of the disease can allow for immediate intervention and thus prevent severity including loss of vision.

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Section: Cedera Iskemikunclassified

Section: Diagnosisunclassified

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Diagnosis dan Tata Laksana Sindrom Tolosa Hunt

Suhendro

2023

Cermin Dunia Kedokteran

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Recurrent Tolosa-Hunt syndrome: a case report

Neupane,

Pudasaini,

Dhakal

et al. 2024

Annals of Medicine &Amp; Surgery

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Introduction and importance: Tolosa-Hunt Syndrome is a rare condition with unknown etiology that manifests clinically as unilateral orbital pain and ophthalmoplegia. It is a diagnosis of exclusion that resolves spontaneously but can recur and respond dramatically to systemic steroids. Case presentation: We herein report a case of a 38-year-old male who presented with horizontal diplopia, limited outward movement of the right eye, and blurry vision for two days which was managed with oral Prednisolone. The patient visited three months later with progressive ptosis and vertical diplopia with periorbital pain over the right eye. It was eventually diagnosed via magnetic imaging resonance studies and successfully treated for Tolosa-Hunt syndrome with IV methylprednisolone followed by oral prednisolone. Clinical discussion: Hence, the typical clinical presentation of the case with significant response to steroids, exclusion of other conditions from investigation and imaging, and subsequent recurrence of similar symptoms were crucial for making the diagnosis of Tolosa-hunt syndrome. Conclusion: Tolosa-Hunt syndrome (THS) is a syndrome of painful ophthalmoplegia which responds well to steroid therapy but has a tendency to recur. Hence, patients must be adequately informed about the reoccurrence and kept under follow-up.

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Diagnosis and Treatment of Tolosa-Hunt Syndrome in the Emergency Department

Cited by 2 publications

References 6 publications

Diagnosis dan Tata Laksana Sindrom Tolosa Hunt

Diagnosis dan Tata Laksana Sindrom Tolosa Hunt

Recurrent Tolosa-Hunt syndrome: a case report

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