A Case of Tolosa-Hunt Syndrome Presented with Headache, Ptosis and Vision Loss

Moon, Myunggi; Yang, Byung Wook; Hong, Seok Jin; Lee, Kyung Chul

doi:2016.23.2.134

J Rhinol > Volume 23(2); 2016

Case Report

Journal of Rhinology 2016;23(2):134-139.
Published online November 30, 2016.
DOI: https://doi.org/10.18787/jr.2016.23.2.134

A Case of Tolosa-Hunt Syndrome Presented with Headache, Ptosis and Vision Loss

Myunggi Moon, Byung Wook Yang, Seok Jin Hong, Kyung Chul Lee

Department of Otolaryngology-Head and Neck Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea. fess0101@hanmail.net

두통, 좌측 안검 하수, 시력 저하를 주소로 내원한 Tolosa-Hunt Syndrome 1례

문명기, 양병욱, 홍석진, 이경철

성균관대학교 의과대학 강북삼성병원 이비인후과-두경부외과학교실

Abstract

Cavernous sinus syndrome (CSS) is defined as the involvement of two or more of the third, fourth, fifth (V1, V2) or sixth cranial nerves or involvement of only one of them in combination with a neuroimaging-confirmed lesion in the cavernous sinus. Some cases of CSS are attributed to Tolosa-Hunt syndrome (THS), an idiopathic inflammatory disease of the cavernous sinus. THS is characterized by painful ophthalmoplegia due to granulomatous inflammation in the cavernous sinus. THS is a diagnosis of exclusion that requires a vigorous series of differential diagnoses, and corticosteroid therapy is known to dramatically resolve clinical findings of THS. We report a case of a patient with painful ophthalmoplegia associated with vision loss, which was suspected to be THS. This patient followed a relatively typical clinical course of THS on steroid pulse therapy. We emphasize the differential diagnosis of THS, its presentation, and treatment.

Key Words: Tolosa-hunt syndrome;Vision loss;High dose steroids