Korean J Pain.  2006 Jun;19(1):104-106. 10.3344/kjp.2006.19.1.104.

Hemifacial Pain Accompanied with Delayed Ipsilateral Abducens Nerve Palsy: Tolosa-Hunt Syndrome

• Shim JK
• Moon JC
• Yoon KB
• Kim WO
• Yoon DM

• KMID: 2278026
• DOI: http://doi.org/10.3344/kjp.2006.19.1.104

Abstract

Tolosa-Hunt syndrome is a rare self-limiting disease that's characterized by painful ophthalmoplegia. It has a relapsing and remitting course, and the pain responds promptly to systemic corticosteroid therapy. Yet it is diagnosed by the exclusion of other major causes involving the superior orbital fissure or cavernous sinus, including trauma, neoplasm, aneurysm and inflammation. Further, the associated ophthalmoplegia may follow days to weeks after the onset of orbital or hemifacial pain. Hence, this condition is often misdiagnosed as atypical facial pain, and so improper management could result in unnecessary suffering of the patient. The following case describes a patient suffering with hemifacial pain associated with ipsilateral abducens nerve palsy, which was evident 2 weeks after the onset of pain, and this was misdiagnosed as trigeminal neuralgia and atypical facial pain.

Keyword

hemifacial pain; ophthalmoplegia; orbital pain; Tolosa-Hunt syndrome

MeSH Terms

Abducens Nerve Diseases*
Abducens Nerve*
Aneurysm
Cavernous Sinus
Facial Pain
Humans
Inflammation
Ophthalmoplegia
Orbit
Tolosa-Hunt Syndrome
Trigeminal Neuralgia