Multiple cranial nerve neuropathies: A case report of Tolosa Hunt Syndrome.

Jasmin JO; Erman C FANDIALAN

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Multiple cranial nerve neuropathies: A case report of Tolosa Hunt Syndrome.

Author: Jasmin JO ¹ ; Erman C. FANDIALAN ¹
Author Information

1. Section of Adult Neurology, Department of Clinical Neurosciences, University of East Ramon Magsaysay Memorial Medical Center, Quezon City, Metro Manila, NCR, Philippines
Publication Type:Case Report
MeSH: Human; Female; Middle Aged: 45-64 Yrs Old; Tolosa-hunt Syndrome; Cavernous Sinus; Cranial Nerves; Ophthalmoplegia
From: Philippine Journal of Neurology 2007;11(2):38-38
CountryPhilippines
Abstract: OBJECTIVES
To report a rare case ofTolosa Hunt syndrome and to present an algorithm on how to approach patients with multiple cranial nerve neuropathies.
INTRODUCTION
Tolosa Hunt syndrome is a rare condition of painful ophthalmoplegia, caused by non-specific granulomatous inflammation in the cavernous sinus, superior orbital fissure or orbit. We present a case of a patient with unilateral headache, ptosis and ophthalmoplegia. The clinical presentation can point to several conditions of the cavernous sinus and a correct diagnosis must be done to insrirure appropriare early management.
CLINICAL PRESENTATION
A 48-year old female, with a 20-day hisrory of lefr frontoparieral headache, prosis of lefr eye and diplopia on horizontal gaze to rhe righr. Hemorologic resrs, CSF examinarions and radiologic srudies were negarive. Corricosreroid therapy was commenced, and symproms improved wirhin 72 hours.
DIAGNOTIC WORK-UP
Tolosa Huntsyndrome is a diagnosis of exclusion requiring careful evaluation to rule out tumor, vascular, infectious, or ocher forms of inflammation in the region of the cavernous sinus.
TREATMENT
Corticosteroids are used to treat the inflammarion.