Dr. CHAITHRA DEMBALA AROOR

Dr.Abdul Rawoof, Dr. ROHIT SHETTY

Abstract

We describe clinical presentation of Tolosa-Hunt syndrome.30 patients satisfying clinical and radiological criteria for Tolosa-Hunt syndrome were included.21 were women and the age distribution were between 35 to 75 years. All patients(100%)presented with painful ophthalmoplegia with the involvement of 2nd cranial nerve [30%],3rd [60 %],4th [30%], 6th [50%], and V1 cranial nerves.MRI brain with contrast showed corresponding lesions conforming to ICHD -3 criteria.CSF analysis revealed elevated protein in 60% cases.All patients responded favorably to pulse methyl prednisolone followed by tapering dose of oral steroids.Tolosa-Hunt syndrome is characterized by recurrent painful ophthalmoplegia due to nonspecific granulomatous inflammation in the anterior cavernous sinus, superior orbital fissure, or orbital apex.The diagnosis is based on findings of painful ophthalmoplegia accompanied cranial nerve palsies and an excellent response to corticosteroids.However,it is a diagnosis of exclusion.

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