NOSOLOGICAL ENTITIES?: The Tolosa-Hunt syndrome

Kline, Lanning B.; Hoyt, William F.

doi:10.1136/jnnp.71.5.577

Cited by 258 publications

(124 citation statements)

References 39 publications

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“…Seventy-five percent of patients who manifest painful ophthalmoplegia will not have the diagnosis of THS [4, 5]. Painful ophthalmoplegia is the consequence of the mass effect on the cavernous sinus which includes trauma, vascular malformation, neoplasm, infection, and inflammation including Tolosa-Hunt syndrome, Wegener's granulomatosis, or orbital pseudotumor [6]. Aside from anatomical compressive lesions, painful ophthalmoplegia can also be effected by giant cell arteritis, ophthalmoplegic migraine, or a diabetic ophthalmoplegia [7].…”

Section: Discussionmentioning

confidence: 99%

A Rare Case of Tolosa-Hunt-Like Syndrome in a Poorly Controlled Diabetes Mellitus

Lasam

Kapur

2016

Case Reports in Medicine

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We report a case of a 50-year-old female with diabetes mellitus who presented with progressive second, third, fifth, sixth, and eighth cranial nerve palsy. Diagnostic investigation revealed hyperglycemic state, and brain imaging showed a right cavernous sinus enhancement suggestive of and consistent with Tolosa-Hunt syndrome. The patient was started on steroids with tight glycemic control for eight weeks; subsequently, the cranial nerve palsies resolved as well as documented resolution of the right cavernous sinus enhancement.

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Section: Discussionmentioning

confidence: 99%

A Rare Case of Tolosa-Hunt-Like Syndrome in a Poorly Controlled Diabetes Mellitus

Lasam

Kapur

2016

Case Reports in Medicine

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“…Tolosa-Hunt syndrome (THS) is an idiopathic inflammatory process that involves the cavernous sinus and/or the superior orbital fissure and manifests with symptoms of ophthalmoplegia and headache 1 . Tolosa-Hunt syndrome has an estimated incidence of one to two cases per million 2 .…”

mentioning

confidence: 99%

“…Tolosa-Hunt syndrome is a benign process during which infiltration of lymphocytes and macrophages into the septae and walls of the cavernous sinus and / or the superior orbital fissure leads to a primarily granulomatous inflammatory reaction which clinically leads to facial pain 1 . The inflammation can in turn affect nerves passing through the cavervous sinus and/or superior orbital fissure.…”

mentioning

confidence: 99%

“…The oculomotor, abducens and trochlear nerves, as well as the ophthalmic branch of the trigeminal nerve, are most commonly involved. As many processes can involve the cavernous sinus and the superior orbital fissure, differential diagnoses may includes: trauma, tumour, cavernous sinus thrombosis, infectious disease, vasculitis, sarcoidosis, diabetes mellitus and ophthalmoplegic migraine 1,3 .…”

mentioning

confidence: 99%

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An Unusual Case of Retro-Orbital Pain with Diplopia

Paci

Wein

Bekhor

2010

Can. j. neurol. sci.

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“…Proptosis, chemosis and hyperaemia of the conjunctiva are frequently present. The inflammatory causes of painful ophthalmoplegia are tied to specific infectious agents, which often spread from the contiguous paranasal sinuses [15]. …”

Section: Introductionmentioning

confidence: 99%

Orbital Actinomycosis Associated with Painful Ophthalmoplegia

Pagliani

Campi

Cavallini³

2006

Ophthalmologica

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Purpose: To evaluate a case of orbital actinomycosis presenting as Tolosa-Hunt syndrome in a patient with a history of carcinomas of the kidney and breast. Methods: A woman with ingravescent painful ophthalmoplegia was brought to our observation. Brain and orbital and total body CT scans showed the presence of two orbital neoformations and a miliary pattern of dissemination in the lung. The initial diagnosis, which pointed to secondary localisations of the previous kidney and breast tumours, was changed to orbital and pulmonary actinomycosis following microbiological analysis of lung biopsy samples. Results: Prolonged antibiotic therapy with synthetic penicillin completely resolved the case. Conclusions: Actinomycosis is a very rare infection that may also affect the orbit and its association with a pulmonary dissemination is highly unusual. It is important to consider this type of infection among the causes of painful ophthalmoplegia.

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NOSOLOGICAL ENTITIES?: The Tolosa-Hunt syndrome

Cited by 258 publications

References 39 publications

A Rare Case of Tolosa-Hunt-Like Syndrome in a Poorly Controlled Diabetes Mellitus

A Rare Case of Tolosa-Hunt-Like Syndrome in a Poorly Controlled Diabetes Mellitus

An Unusual Case of Retro-Orbital Pain with Diplopia

Orbital Actinomycosis Associated with Painful Ophthalmoplegia

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