J Rhinol.  2009 May;16(1):65-67.

A Case of Tolosa-Hunt Syndrome

• Kang IG
• Jung JH
• Kim ST
• Cha HE

Abstract

Tolosa-Hunt syndrome (cavernoussinusitis) is a term used to describe diseases involving the content of the superior orbital fissure and/or anterior cavernous sinus, presenting as painful ophthalmoplegia, along with granulomatous inflammation. The third, fourth, fifth and sixth cranial nerves pass through the carvenous sinus. Thus, when infection spreads into the cavernous sinus, these cranial nerves may be paralyzed and corneal reflexes may disappear. Pain and hypoesthesia of the area, which is innervated by the maxillary branch of the fifth nerve, can be accompanied with this syndrome. Tolosa-Hunt syndrome can be improved dramatically with high-dose steroid therapy. A 15-year-old boy who had retro-orbital pain, diplopia and exophthalmos was diagnosed with sphenoid sinusitis by PNS CT. He underwent brain MRI and neurologic examination because the symptoms persisted after the endoscopic sinus surgery. He was finally diagnosed with Tolosa-Hunt syndrome and his symptoms were improved with steroid therapy.

Keyword

Tolosa-hunt syndrome; Sphenoid Sinusitis; Steroid

MeSH Terms

Abducens Nerve
Adolescent
Blinking
Brain
Cavernous Sinus
Cranial Nerves
Diplopia
Exophthalmos
Humans
Hypesthesia
Inflammation
Neurologic Examination
Ophthalmoplegia
Orbit
Sphenoid Sinus
Sphenoid Sinusitis
Tolosa-Hunt Syndrome