Publication: Tolosa-Hunt Syndrome: A Case Report Authors
Date
2021
Journal Title
Journal ISSN
Volume Title
Publisher
Nepal Medical Association
Abstract
Abstract:
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.
Description
Siddhanta K.C.
Kathmandu Medical College and Teaching Hospital, Sinamangal, Kathmandu, Nepal
Shreeyanta K.C.
Dirghayu Guru Hospital, Chabahil, Kathmandu, Nepal
Prajjwal Kunwar
HAMS Hospital, Dhumbarahi, Kathmandu, Nepal
Krishna Dhungana
Department of Neurology, Kathmandu Medical College and Teaching Hospital, Sinamangal, Kathmandu, Nepal
Keywords
painful opthalmoplegia, ptosis, Tolosa-Hunt Syndrome