Paquimeningitis hipertrófica. Revisión histórica a propósito de dos casos y relación patogénica con el síndrome de Tolosa­Hunt y el pseudotumor orbitario

Painful ophthalmoplegia (PO) is an important presenting problem to ophthalmologists and neurologists. The etiological differential diagnosis is extensive, including different syndromes and causes (vascular, neoplastic, infectivous, inflammatory). Current neuroimaging techniques allow visualisation of the area of the suspected pathology. Some rare causes of PO, such as Tolosa Hunt syndrome with negative neuroimaging findings or ophthalmoplegic migraine remain till now of uncertain classification. Correct approach to the patient requires correlation to clinical data and careful monitoring, to avoid diagnostic mistakes, as the "history" of Tolosa-Hunt syndrome has underlined.

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The evaluation of ICHD-3 beta diagnostic criteria for Tolosa–Hunt syndrome: a study of 22 cases of Tolosa–Hunt syndrome

Hao

Zhang

et al. 2015

Neurol Sci

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The objective of the study was to evaluate the amended International Classification of Headache Disorders (third edition, beta version, ICHD-3 beta) with a retrospective analysis. A total of 22 patients diagnosed with painful ophthalmoplegia and Tolosa-Hunt syndrome (THS) in our hospital were retrospectively studied. The following clinical data were collected: symptoms, signs, location of inflammatory tissue, time interval of paresis following the onset of pain, pain and signs of resolution, follow-up and relapse. Pain and diplopia were found in 22 (100 %) and 20 cases (91 %). The sympathetic nerve was involved in 6 cases (27 %). Paresis followed the pain for an average of 8 ± 5.87 days. Serial magnetic resonance imaging (MRI) revealed granulomatous lesion that was visible in 20 patients (91 %). 19 patients (86 %) demonstrated the lesions located in the cavernous sinus, orbital apex or superior orbital fissure. One lesion extended to the intracranial structure. Pain was relieved in 20 cases (91 %) within 72 h and no patient had complete relief from paresis. According to our study, we think the time course of relief should be undefined. Headache location is hard to describe accurately. Normal MRI should be involved in THS diagnoses. The lesion of THS can extend beyond the cavernous sinus and the orbit. The time interval between headache and paresis can exceed 2 weeks.

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Paquimeningitis hipertrófica. Revisión histórica a propósito de dos casos y relación patogénica con el síndrome de TolosaHunt y el pseudotumor orbitario

Cited by 11 publications

References 0 publications

Neuroradiological and clinical features in ophthalmoplegia

Neuroradiological and clinical features in ophthalmoplegia

Painful ophthalmoplegia: an unresolved clinical problem

The evaluation of ICHD-3 beta diagnostic criteria for Tolosa–Hunt syndrome: a study of 22 cases of Tolosa–Hunt syndrome

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Paquimeningitis hipertrófica. Revisión histórica a propósito de dos casos y relación patogénica con el síndrome de Tolosa­Hunt y el pseudotumor orbitario

Cited by 11 publications

References 0 publications

Neuroradiological and clinical features in ophthalmoplegia

Neuroradiological and clinical features in ophthalmoplegia

Painful ophthalmoplegia: an unresolved clinical problem

The evaluation of ICHD-3 beta diagnostic criteria for Tolosa–Hunt syndrome: a study of 22 cases of Tolosa–Hunt syndrome

Contact Info

Product

Resources

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Paquimeningitis hipertrófica. Revisión histórica a propósito de dos casos y relación patogénica con el síndrome de TolosaHunt y el pseudotumor orbitario