The Tolosa-Hunt syndrome

Kline, Lanning B.

doi:10.1016/0039-6257(82)90190-4

Cited by 131 publications

(74 citation statements)

References 55 publications

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“…[69][70][71][72] Rarely, involvement of the orbital apex or extension of the pathologic process may produce an optic neuropathy, cause a facial paralysis, or involve the mandibular or maxillary branches of the trigeminal nerve. Although unilateral involvement is typical, patients may experience bilateral disease and may develop recurrences.…”

Section: Orbital Involvement In Oidmentioning

confidence: 99%

Orbital inflammatory disease: a diagnostic and therapeutic challenge

Gordon

2006

Eye

177

115

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Section: Orbital Involvement In Oidmentioning

confidence: 99%

Orbital inflammatory disease: a diagnostic and therapeutic challenge

Gordon

2006

Eye

177

115

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“…Chama a atenção, em nossa casuística, o predomínio absoluto do sexo feminino, contrário aos principais registros da literatura 4,6,7 , que não citam preponderância de sexo na STH. No entanto, o número de pacientes em nosso estudo é pequeno para que alguma conclusão possa ser firmada a esse respeito.…”

Section: Discussionunclassified

“…Atualmente existem mais de 250 casos relatados na literatura e apenas cerca de 10% foram submetidos a estudo anátomo-patológico ou biópsia da parede do seio cavernoso com estudo histopatológico, nada além de uma reação granulomatosa inespecífica tendo sido observado 7,13 . Em alguns casos havia necrose e células gigantes multinucleadas, levantando a possibilidade de associação com a arterite temporal.…”

Section: Discussionunclassified

“…Alguns autores 3,10 fomentam até a hipótese de ambos serem manifestações regionais polares de uma mesma entidade, já que possuem vários pontos em comum: grande sensiblidade a corticóides, mesmas características radiológicas, inclusive na ressonância nuclear magnética (RNM), além de padrão histológico muito próximo. Além disso, exoftalmia de 2 até 6 milímetros foi observada em 18% dos pacientes compilados por Kline 7 Apresentamos o estudo clínico-laboratorial de cinco pacientes com STH, objetivando detalhar o padrão de resposta clínica ao uso da prednisona.…”

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Síndrome de Tolosa-Hunt: dificuldades no diagnóstico e padrão de resposta à prednisona

Carrilho

Yamamoto

Scaff

1997

Arq. Neuro-Psiquiatr.

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RESUMO -A síndrome de Tolosa-Hunt (STH) consiste de oftalmoplegia dolorosa relacionada a processo inílamatório granulomatoso no seio cavernoso. Seu diagnóstico só pode ser firmado quando outras causas potenciais de oftalmoplegia dolorosa forem descartadas. Resposta satisfatória e padronizada a corticosteróides, associada a evolução benigna, pode reforçar essa possibilidade, embora pseudotumor orbitário e neoplasias do tipo linfoma e até meningioma possam suscitar dúvidas no diagnóstico diferencial, pois também podem apresentar boa resposta a essa medicação. Faz-se necessário, portanto, ampla investigação complementar. Apresentamos estudo clínico-radiológico-laboratorial de cinco pacientes com STH. Prednisona foi utilizada em doses entre 40 e 80 mg/dia. Houve resposta analgésica excelente, com remissão da dor em menos de 48 horas em 4 pacientes. Houve melhora mais lenta da oftalmoplegia, que regrediu completamenteentre 4 e 45 dias em todos os pacientes.PALAVRAS-CHAVE: síndrome de Tolosa Hunt, oftalmoplegia, doenças orbitárias, prednisona. Tolosa-Hunt syndrome: troubles in diagnosing and pattern of response to prednisoneABSTRACT -The Tolosa-Hunt syndrome (THS) consists of a painful ophthalmoplegia related to granulomatous inflammatory process in the cavernous sinus. According to recent concepts, the diagnosis is established only when other causes of painful ophthalmoplegia are ruled out. A typical pattern of response to corticosteroids associated with a benign evolution may reinforce this possibility. Tumors such as lymphoma and meningioma and orbital pseudotumors can make difficult the differential diagnosis because they also may respond to steroids. Thus it is always necessary to make an extensive ancillary investigation. We performed a clinical, laboratory and radiologic study of five patients with THS. Prednisone was used in all, with dosages ranging from 40 to 80 mg/day. In four patients there was a dramatic analgesic effect in less than 48 hours. Improvement of the ophthalmoplegia was not so fast but occurred in all with a complete remission in 4 to 45 days.

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“…THS is usually reported as unilateral, with no predilection to right or left cavernous sinus, While 4.1-5% of THS is bilateral [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19]. Uniformly, patients complain of pain, which is a defining symptom.…”

Section: Introductionmentioning

confidence: 99%

Tolosa Hunt Syndrome: Increased Severity on Second Attack

Alzu’bi¹

2016

J Gen Pract

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Tolosa Hunt syndrome (THS) is a rare cause of painful ophthalmoplegia with an estimated annual incidence of 1 case per million per year. It is caused by a nonspecific inflammatory process, of unknown etiology, involving the cavernous sinus, the superior orbital fissure and/or the orbital apex. It is classically described as an episodic orbital pain associated with paralysis of one or more of the 3rd, 4th and 6th cranial nerves, resolving spontaneously or with the commencement of steroids. I report a female patient who had 2 attacks of THS separated by a period of 10 months. She presented with retro-orbital headache, exophthalmos, and ophthalmoplegia of left eye, on both attacks, and was treated with high dose prednisolone. On first attack she improved within 6 weeks of treatment. On second attack, the patient had a higher Erythrocyte sedimentation rate (ESR) and developed 2 relapses on corticosteroids tapering, requiring a prolonged course of treatment, for 27 weeks, which suggests that the disease activity may get more severe on further attacks of the disease.

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The Tolosa-Hunt syndrome

Cited by 131 publications

References 55 publications

Orbital inflammatory disease: a diagnostic and therapeutic challenge

Orbital inflammatory disease: a diagnostic and therapeutic challenge

Síndrome de Tolosa-Hunt: dificuldades no diagnóstico e padrão de resposta à prednisona

Tolosa Hunt Syndrome: Increased Severity on Second Attack

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