Painful ophthalmoplegia of the left eye in a 19-year-old female, with an emphasis in Tolosa-Hunt syndrome: a case report.

Abstract

INTRODUCTION:

Painful ophthalmoplegia refers to periorbital or hemicraneal pain plus ipsilateral ocular motor nerve palsies with or without oculo-sympathetic paralysis, sensory loss in the distribution of V1 and V2 can co-occur. There are many etiologies of painful ophthalmoplegia. Tolosa-Hunt syndrome is a steroid-responsive painful ophthalmoplegia secondary to idiopatic granulomatous inflammation of the cavernous sinus or orbital apex. THS is a diagnosis of exclusion and treatment should be with high dose steroid.

CASE PRESENTATION:

We describe the case of a 19-year-old female that was admitted to our hospital for painful ophthalmoplegia of the left eye. After the diagnostic work-up, we concluded that the patient had a benign form of Tolosa-Hunt syndrome. We initiated treatment with steroids and 72 hours later saw a response.

CONCLUSION:

In conclusion, steroid treatment is the cornerstone in the management of THS. Even though there is no standardized dose specified in the literature, this type of treatment with steroids at a dose of 1 mg/kg/day tapered slowly over 3 to 4 months has been well received.

• Authors: Juan A Mendez, Cristhian R Arias, Diego Sanchez, Luis M Pesci, Brenda S Lopez, Ruben Lopez, Elvira Castro
• Journal: Cases journal (Cases J) Vol. 2 Pg. 8271 (Sep 17 2009) ISSN: 1757-1626 [Electronic] England
• PMID: 19918410 (Publication Type: Case Reports)