Abstract
A case of painful ophthalmoplegia due to idiopathic granulomatous involvement of the superior orbital fissure (Tolosa-Hunt syndrome) is described. The clinical features of recurrent pain, ocular motor nerve palsies and proptosis correlated well with the eventual demonstration of an enhancing mass in the region of the cavernous sinus. Removal of the lesion led to a resolution of the clinical picture and demonstration of a non-caseating granuloma with no other detectable cause. The original observation of Tolosa was thus re-affirmed.
Full text
PDF
Images in this article
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- HUNT W. E., MEAGHER J. N., LEFEVER H. E., ZEMAN W. Painful opthalmoplegia. Its relation to indolent inflammation of the carvernous sinus. Neurology. 1961 Jan;11:56–62. doi: 10.1212/wnl.11.1.56. [DOI] [PubMed] [Google Scholar]
- Hannerz J. Pain characteristics of painful ophthalmoplegia (the Tolosa-Hunt syndrome). Cephalalgia. 1985 Jun;5(2):103–106. doi: 10.1046/j.1468-2982.1985.0502103.x. [DOI] [PubMed] [Google Scholar]
- Hannerz J. Pathoanatomic studies in a case of Tolosa-Hunt syndrome. Cephalalgia. 1988 Mar;8(1):25–30. doi: 10.1046/j.1468-2982.1988.0801025.x. [DOI] [PubMed] [Google Scholar]
- LAKKE J. P. Superior orbital fissure syndrome. Report of a case caused by local pachymeningitis. Arch Neurol. 1962 Oct;7:289–300. doi: 10.1001/archneur.1962.04210040041004. [DOI] [PubMed] [Google Scholar]
- Neigel J. M., Rootman J., Robinson R. G., Durity F. A., Nugent R. A. The Tolosa-Hunt syndrome: computed tomographic changes and reversal after steroid therapy. Can J Ophthalmol. 1986 Dec;21(7):287–290. [PubMed] [Google Scholar]
- Sondheimer F. K., Knapp J. Angiographic findings in the Tolosa-Hunt syndrome: painful ophthalmoplegia. Radiology. 1973 Jan;106(1):105–112. doi: 10.1148/106.1.105. [DOI] [PubMed] [Google Scholar]
- TOLOSA E. Periarteritic lesions of the carotid siphon with the clinical features of a carotid infraclinoidal aneurysm. J Neurol Neurosurg Psychiatry. 1954 Nov;17(4):300–302. doi: 10.1136/jnnp.17.4.300. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Thomas D. J., Charlesworth M. C., Afshar F., Galton D. J. Computerised axial tomography and magnetic resonance scanning in the Tolosa-Hunt syndrome. Br J Ophthalmol. 1988 Apr;72(4):299–302. doi: 10.1136/bjo.72.4.299. [DOI] [PMC free article] [PubMed] [Google Scholar]