Tolosa-Hunt syndrome is a rare cause of painful ophthalmoplegia accompanied by ipsilateral ocular motor palsies, oculosympathetic paralysis and peri-orbital pain around the distribution of the ophthalmic division of the trigeminal nerve. Though the cause is unknown, idiopathic inflammation has been implicated. The pathology can be localized in the cavernous sinus, superior orbital fissure or the apex of the orbital cavity. Localization of the pathology requires a combination of careful history, physical examination and imaging, preferably MRI. We present a 40 year old Kenyan female patient with Tolosa-Hunt syndrome. She presented with left-sided periorbital headache and ptosis. Further examination revealed left-sided trochlear and abducens palsy, and partial left-sided oculomotor palsy. She had allodynia and hyperesthesia on the distribution of the left ophthalmic division of the trigeminal nerve. After an initial normal head CT scan, a magnetic resonance imaging revealed a soft-tissue hyperintensity extending from the left cavernous sinus, superior orbital fissure and apex of the orbit. She responded positively to steroid therapy, with cessation of headaches, correction of ptosis and ophthalmoplegia and an improved quality of life. There was minimal improvement in vision, with persisting pallor of the disc. This case shines the spotlight on a relatively rare disorder; whose diagnosis requires careful history, examination and interpretation of MRI findings.
| Published in | World Journal of Medical Case Reports (Volume 4, Issue 3) |
| DOI | 10.11648/j.wjmcr.20230403.11 |
| Page(s) | 32-34 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
| Copyright |
Copyright © The Author(s), 2023. Published by Science Publishing Group |
Tolosa-Hunt, Ophthalmoplegia, Ptosi, MRI
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APA Style
Paul Bundi Karau, Winnie Mueni Saumu. (2023). Tolosa-Hunt Syndrome in a Kenyan Patient: Case Report and Review of the Literature. World Journal of Medical Case Reports, 4(3), 32-34. https://doi.org/10.11648/j.wjmcr.20230403.11
ACS Style
Paul Bundi Karau; Winnie Mueni Saumu. Tolosa-Hunt Syndrome in a Kenyan Patient: Case Report and Review of the Literature. World J. Med. Case Rep. 2023, 4(3), 32-34. doi: 10.11648/j.wjmcr.20230403.11
AMA Style
Paul Bundi Karau, Winnie Mueni Saumu. Tolosa-Hunt Syndrome in a Kenyan Patient: Case Report and Review of the Literature. World J Med Case Rep. 2023;4(3):32-34. doi: 10.11648/j.wjmcr.20230403.11
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Download@article{10.11648/j.wjmcr.20230403.11,
author = {Paul Bundi Karau and Winnie Mueni Saumu},
title = {Tolosa-Hunt Syndrome in a Kenyan Patient: Case Report and Review of the Literature},
journal = {World Journal of Medical Case Reports},
volume = {4},
number = {3},
pages = {32-34},
doi = {10.11648/j.wjmcr.20230403.11},
url = {https://doi.org/10.11648/j.wjmcr.20230403.11},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.wjmcr.20230403.11},
abstract = {Tolosa-Hunt syndrome is a rare cause of painful ophthalmoplegia accompanied by ipsilateral ocular motor palsies, oculosympathetic paralysis and peri-orbital pain around the distribution of the ophthalmic division of the trigeminal nerve. Though the cause is unknown, idiopathic inflammation has been implicated. The pathology can be localized in the cavernous sinus, superior orbital fissure or the apex of the orbital cavity. Localization of the pathology requires a combination of careful history, physical examination and imaging, preferably MRI. We present a 40 year old Kenyan female patient with Tolosa-Hunt syndrome. She presented with left-sided periorbital headache and ptosis. Further examination revealed left-sided trochlear and abducens palsy, and partial left-sided oculomotor palsy. She had allodynia and hyperesthesia on the distribution of the left ophthalmic division of the trigeminal nerve. After an initial normal head CT scan, a magnetic resonance imaging revealed a soft-tissue hyperintensity extending from the left cavernous sinus, superior orbital fissure and apex of the orbit. She responded positively to steroid therapy, with cessation of headaches, correction of ptosis and ophthalmoplegia and an improved quality of life. There was minimal improvement in vision, with persisting pallor of the disc. This case shines the spotlight on a relatively rare disorder; whose diagnosis requires careful history, examination and interpretation of MRI findings.},
year = {2023}
}
TY - JOUR T1 - Tolosa-Hunt Syndrome in a Kenyan Patient: Case Report and Review of the Literature AU - Paul Bundi Karau AU - Winnie Mueni Saumu Y1 - 2023/07/20 PY - 2023 N1 - https://doi.org/10.11648/j.wjmcr.20230403.11 DO - 10.11648/j.wjmcr.20230403.11 T2 - World Journal of Medical Case Reports JF - World Journal of Medical Case Reports JO - World Journal of Medical Case Reports SP - 32 EP - 34 PB - Science Publishing Group SN - 2994-726X UR - https://doi.org/10.11648/j.wjmcr.20230403.11 AB - Tolosa-Hunt syndrome is a rare cause of painful ophthalmoplegia accompanied by ipsilateral ocular motor palsies, oculosympathetic paralysis and peri-orbital pain around the distribution of the ophthalmic division of the trigeminal nerve. Though the cause is unknown, idiopathic inflammation has been implicated. The pathology can be localized in the cavernous sinus, superior orbital fissure or the apex of the orbital cavity. Localization of the pathology requires a combination of careful history, physical examination and imaging, preferably MRI. We present a 40 year old Kenyan female patient with Tolosa-Hunt syndrome. She presented with left-sided periorbital headache and ptosis. Further examination revealed left-sided trochlear and abducens palsy, and partial left-sided oculomotor palsy. She had allodynia and hyperesthesia on the distribution of the left ophthalmic division of the trigeminal nerve. After an initial normal head CT scan, a magnetic resonance imaging revealed a soft-tissue hyperintensity extending from the left cavernous sinus, superior orbital fissure and apex of the orbit. She responded positively to steroid therapy, with cessation of headaches, correction of ptosis and ophthalmoplegia and an improved quality of life. There was minimal improvement in vision, with persisting pallor of the disc. This case shines the spotlight on a relatively rare disorder; whose diagnosis requires careful history, examination and interpretation of MRI findings. VL - 4 IS - 3 ER -
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