Tolosa-Hunt syndrome preceded by facial palsy in a child.

Abstract

We report on a previously healthy 11-year-old boy with unilateral periorbital mild headache and facial nerve palsy, followed during the next 5 months by recurrent unilateral headaches and subsequent extrinsic paresis of the third cranial nerve and paresis of the sixth cranial nerve, each of which improved with steroids. Cranial magnetic resonance imaging revealed increased thickening of the left cavernous sinus and adjacent structures, with marked gadolinium enhancement. Eight months after the initial signs, he developed left retro-orbital headache that lasted 16 days and was relieved 24 hours after resuming steroid treatment. Recurrent multiple cranial neuropathies, neuroimaging findings, and long-lasting headache that responded to steroids indicated Tolosa-Hunt syndrome, further confirmed by extensive investigation and a long follow-up to exclude other causes. This patient illustrates the complexity of disorders with multiple cranial nerve palsies, and adds to the sparse literature on Tolosa-Hunt syndrome in children, describing the first pediatric case preceded by facial palsy.

• Authors: Alfredo Cerisola, Gabriel González, Cristina Scavone
• Journal: Pediatric neurology (Pediatr Neurol) Vol. 44 Issue 1 Pg. 61-4 (Jan 2011) ISSN: 1873-5150 [Electronic] United States
• PMID: 21147390 (Publication Type: Case Reports, Journal Article)
• Copyright: Copyright © 2011 Elsevier Inc. All rights reserved.

Chemical References

• Anti-Inflammatory Agents
• Prednisone

Topics

• Anti-Inflammatory Agents (therapeutic use)
• Cavernous Sinus (pathology)
• Child
• Cranial Nerve Diseases (complications, drug therapy, pathology)
• Diplopia (etiology)
• Facial Paralysis (complications, pathology)
• Headache (etiology)
• Humans
• Magnetic Resonance Imaging
• Male
• Prednisone (therapeutic use)
• Tolosa-Hunt Syndrome (complications, drug therapy, pathology)
• Tomography, X-Ray Computed