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

Cases Journal
Juan A MendezElvira Castro

Abstract

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. 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. 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.

References

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Aug 10, 2007·Current Pain and Headache Reports·Jonathan P Gladstone

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Citations

Sep 11, 2012·Clinical & Experimental Optometry : Journal of the Australian Optometrical Association·Maria MiliaMiltiadis Papathanassiou
Oct 19, 2016·Medicina clínica·Raquel Cenjor Martín
Feb 18, 2017·Journal of Investigative Medicine High Impact Case Reports·Ghulam MurtazaAneesh Kuruvilla

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Methods Mentioned

BETA
biopsy
ELISA
PCR

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