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tolosa hunt syndrome

Kalpana Babu, Deepika C Parameswarappa
Purpose: We report an interesting case of atypical Tolosa Hunt syndrome with bilateral Sclerokeratitis and optic atrophy in a patient with Takayasu's arteritis. Observations: A 31-year- old lady presented with severe retroorbital pain in the right eye and right sided headache of 2 weeks duration. She had a history of 6th and 7th nerve palsies which improved with oral corticosteroids. Her BCVA was no perception of light in OD and 6/6 in OS. Slitlamp examination showed bilateral old sclerokeratitis and fundus examination showed bilateral optic atrophy...
April 2017: American Journal of Ophthalmology Case Reports
Sandra Zečević Penić, Marijana Lisak, Tomislav Gregurić, Hrvoje Hećimović, Vanja Bašić Kes
This case report presents a patient diagnosed with Tolosa-Hunt syndrome (THS) after an extensive neuro-diagnostic and neuroimaging evaluation. Diagnostic work-up included thorough physical and neurological examination, complete laboratory serum assessments, neuroendocrine and immunohistochemistry analysis, cerebrospinal fluid analysis, neurophysiology assessment, ophthalmologist examination and neuroimaging. Th e most important diagnostic tool in deriving the diagnosis of THS was neuroimaging evaluation that included baseline and follow-up cranial contrast enhanced magnetic resonance imaging (MRI)...
June 2017: Acta Clinica Croatica
Evan Mullen, Mark Green, Eliza Hersh, Alfred-Marc Iloreta, Joshua Bederson, Raj Shrivastava
Introduction The term Tolosa-Hunt Syndrome was first used more than half a century ago to describe painful ophthalmoplegia accompanied by cranial nerve palsies. In the decades since, its diagnostic criteria have evolved considerably. The beta version of the 3rd Edition of the International Classification of Headache Disorders narrows these criteria to require the demonstration of granulomatous inflammation on MRI or biopsy. We believe this may introduce challenges to accurate diagnosis. Discussion Requiring the demonstration of granulomatous inflammation for a diagnosis of Tolosa-Hunt Syndrome may introduce the potential for false negative and false positive diagnoses...
January 1, 2017: Cephalalgia: An International Journal of Headache
Çetin Kürşad Akpinar, Taner Özbenli, Hakan Doğru, Lütfi Incesu
INTRODUCTION: The etiology of Tolosa-Hunt Syndrome (THS) is still unknown. The initial standard magnetic resonance imaging (MRI) may not be sufficient for diagnosis, so dynamic contrast-enhanced MRI may be necessary to demonstrate the presence of lesions. METHODS: Seven patients diagnosed with THS according to the International Headache Society criteria (beta version) were included into the study. Patients were assessed in terms of type, age, symptoms and findings, accompanying disease, localization of the determined lesion, response to treatment, and clinical progress...
September 2017: Noro Psikiyatri Arsivi
Renata Świątkowska-Stodulska, Dominik Stodulski, Anna Babińska, Maciej Piskunowicz, Krzysztof Sworczak
The authors report a rare case of bilateral Tolosa-Hunt syndrome, which occurred in a 80-year-old female and remitted spontaneously. Inflammatory lesions were found not only in typical locations, i.e. superior orbital fissures and cavernous sinuses, but also in the pituitary; these imitated gland's macroadenoma in imaging studies.
December 2017: Endocrine
Kwo Wei David Ho, Peter A Drew, Miguel Chuquilin
Merkel cell carcinoma (MCC) is an uncommon but highly malignant neuroendocrine tumor of the skin. MCC can metastasize, but involvement of the central nervous system is rare. Here, we report a case of rapidly progressing metastatic MCC to the clivus and bilateral cavernous sinus in an immunocompromised patient. This case is unique in that it is the first case report showing MCC metastasis to the clivus from a distant site. It also demonstrates that a MCC metastasis can masquerade with symptoms of Tolosa-Hunt syndrome...
2017: Frontiers in Neurology
Sofia Torreggiani, Claudia Maria Cinnante, Marta Torcoletti, Fabrizia Corona, Carlo Agostoni, Giovanni Filocamo
May 2017: Clinical and Experimental Rheumatology
Jaydeep Majumdar, Sarmishtha Mukhopadhyay, Abhijeet Sharan, Sarbani Sengupta, Bhaskar Ghosh
Tolosa- Hunt syndrome is a rare steroid responsive disorder caused by granulation tissue involving the cavernous sinus or superior orbital fissure presenting as painful ophthalmoplegia and facial pain. In this report, we describe coexistence of Tolosa-Hunt syndrome with ocular myasthenia which may point towards an autoimmune etiological basis behind the cavernous sinus granulation tissue formation and also offered therapeutic challenge to ameliorate the symptoms.
February 2017: Journal of the Association of Physicians of India
Stefan Evers
Premise This review summarises the pain syndromes that overlap between headache and facial pain and overlap between pain and cranial nerve lesion. Problem These syndromes share two features in common. First, they show both cranial nerve impairment (e.g. palsy, autonomic dysfunction) and pain; second, they have inflammatory (and/or small vessel) processes as the underlying mechanism. A typical representative of these syndromes is recurrent painful ophthalmoplegic neuropathy, which was previously called ophthalmoplegic migraine and was regarded as a migraine subtype...
June 2017: Cephalalgia: An International Journal of Headache
Tomohiro Ota, Mineo Yamazaki, Yusuke Toda, Akiko Ozawa, Kazumi Kimura
A 66-year-old man presented with headache and ophthalmalgia. Diplopia developed, and he was hospitalized. The left eye had abducent paralysis and proptosis. We diagnosed him with Tolosa-Hunt syndrome and administered methylprednisolone at 1 g/day for 3 days. However, the patient did not respond to treatment. No abnormality was found on his MRI or cerebrospinal fluid examination. Tests showed his serum immunoglobulin G4 and antineutrophil cytoplasmic antibody titers were within normal limits. He also had untreated diabetes mellitus (HbA1c 9...
April 28, 2017: Rinshō Shinkeigaku, Clinical Neurology
Nisar A Wani, Majid Jehangir, Parveen A Lone
PURPOSE: To highlight the role of constructive interference steady state (CISS) magnetic resonance imaging (MRI) in the diagnosis of Tolosa-Hunt Syndrome (THS). CASE REPORT: We describe a case of THS in a 55-year-old woman presenting with left painful opthalmoplegia that was diagnosed by CISS MRI. Patient responded to steroid treatment and the lesion resolved. CONCLUSION: Imaging with MRI can help in making the diagnosis of THS by demonstrating an enhancing soft tissue lesion in the cavernous sinus and orbital apex resolving with steroids...
January 2017: Journal of Ophthalmic & Vision Research
Charles E Litwin, Annie S O Leung
No abstract text is available yet for this article.
June 2017: International Journal of Gynaecology and Obstetrics
S Bhatkar, M K Goyal, A Takkar, K K Mukherjee, P Singh, R Singh, V Lal
OBJECTIVES: To study the clinical and etiological profile of patients with cavernous sinus syndrome (CSS) and identify factors which could determine the etiology and influence the outcome of these patients. PATIENTS AND METHODS: This prospective observational study included 73 consecutive patients satisfying the criteria of CSS (i.e. involvement of any 2 of the 3rd, 4th, 5th and 6th cranial nerves or any one of them with radiological evidence of cavernous sinus involvement)...
April 2017: Clinical Neurology and Neurosurgery
Ghulam Murtaza, Nicholas Konowitz, Hannah Lu, Anadil Faqah, Aneesh Kuruvilla
Tolosa-Hunt syndrome is a rare disease with a limited number of cases reported in the literature. It typically presents with orbital pain associated with palsy of the third, fourth, or sixth cranial nerve. We present an interesting case of Tolosa-Hunt syndrome in a young male who responded well to high-dose steroids and in a few days had significant improvement in his retro-orbital pain and ocular movements.
January 2017: Journal of Investigative Medicine High Impact Case Reports
Hiroshi Takasuna, Rie Sasaki, Makoto Shiraishi, Masatomo Doi, Daisuke Wakui, Hidemichi Ito, Kotaro Oshio, Yuichiro Tanaka
BACKGROUND: We report a case of steroid-resistant Tolosa-Hunt syndrome (THS) with recurrent bilateral painful ophthalmoplegia, accompanied with sphenoid sinusitis, pituitary abscess, and an aneurysm arising from the cavernous portion of the internal carotid artery. CASE DESCRIPTION: A 53-year-old woman suffered severe left painful ophthalmoplegia. A magnetic resonance image (MRI) revealed thickness of the left cavernous sinus (CS). Steroid was administrated under the diagnosis of THS, and the symptom transiently diminished...
2016: Surgical Neurology International
Mehmet Emin Ceylan, Alper Evrensel, Cemal Onur Noyan, Aslıhan Dönmez
No abstract text is available yet for this article.
November 21, 2016: BMJ Case Reports
Carlos A Pérez, Monaliza Evangelista
BACKGROUND: Tolosa-Hunt syndrome is a painful ophthalmoplegia caused by an inflammatory process of unknown etiology in the region of the cavernous sinus, orbital apex, or superior orbital fissure. This disease is rare in the pediatric population. The objective of this study was to provide a clinical framework for the evaluation and treatment of children with this disorder. A systematic approach to the diagnosis of painful ophthalmoplegia in children is proposed. METHODS: We present a 15-year-old girl whose clinical presentation and neuroradiological findings support a diagnosis of Tolosa-Hunt syndrome as defined by the 2013 International Classification of Headache Disorders (Third Edition, ICHD-3 beta) diagnostic criteria...
September 2016: Pediatric Neurology
Amol Raheja, Aleksandra Sowder, Cheryl Palmer, Fausto J Rodriguez, William T Couldwell
Epstein-Barr virus (EBV)-associated smooth muscle tumors (SMTs) have recently been associated with primary and secondary immunodeficiencies. They are broadly divided into 3 subgroups: HIV-related, posttransplant, and congenital immunodeficiency. Subsequent to organ transplantation and acquired immunosuppression, a few cases of EBV-associated SMTs have been described in the liver, respiratory tract, and gastrointestinal system. To the authors' knowledge, intracranial involvement after peripheral blood stem cell transplantation has never been reported previously...
May 2017: Journal of Neurosurgery
V Dclreux, L Kevers, A Callewaert
The authors report a case of pituitary apoplexy whose sole clinical manifestation was painful ophtalmoplegia. No other neurological, endocrine or visual symptoms were present. The classic investigations (radiological findings as computed tomography, endocrine and visual investigations, biology) were normal. The reasons of this are the small size of the pituitary adenoma, the absence of upward enlargment or secretion. This case illustrates the carefulness necessary before concluding to the Tolosa-Hunt syndrome and the ophthalmoplegia migraine, which are diagnoses of exclusion of painful ophthalmoplegia...
January 1988: Acta Clinica Belgica
Ilko Kastirr, Peter Kamusella, Reimer Andresen
We present the case of a man of 47 years with vertical and horizontal paresis of view combined with periorbital pain that developed initially on the right side but extended after 3-4 days to the left. Gadolinum uptaking tissue in the cavernous sinus was shown by MRI of the orbital region in the T1 spin echo sequence with fat saturation (SEfs) with a slice thickness of 2 mm. As no other abnormalities were found and the pain resolved within 72 hours of treatment with cortison a bilateral Tolosa-Hunt Syndrome (THS) was assumed...
March 2016: Journal of Clinical and Diagnostic Research: JCDR
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