Case Report: Tolosa-Hunt syndrome, a neuroinflammatory origin of painful ophthalmoplegia

• DOI: 10.12688/f1000research.142749.2
• Publication Date: 2024-08-20T15:45:21Z
• Authors: Amro Abdelrahman; Moayad Elgassim; Asmaa Abdalkarim; Anas Mohamed Babiker; Muhnad Abdeen; Shahd M. Abass; Isra Babiker; Gufran Algaly; Khalid Y. Fadul; Sara M.I. Ahmed; Fajr Jamal A. Bagi; Muhammad Abugabala; Amin Saied; Mohamed Elgassim
• Keywords: Tolosa–Hunt syndrome; Open peer review

<ns3:p>Background Tolosa-Hunt syndrome is a rare neuroinflammatory disease that affects the cavernous sinus and superior orbital fissure, resulting in symptoms of neuropathy. Case presentation We report case 35-year-old male patient with no past medical history who presented to emergency department (ED) complaining four-day progressively increasing headaches associated right eye pain double vision. A physical examination showed findings suggestive abducens nerve palsy. computed tomography (CT) scan subtle asymmetric thickening sinus, which prompted further investigation by magnetic resonance imaging (MRI) scan. The MRI intensely enhanced soft tissue region, slightly extending apex, caused enlargement appeared isointense adjacent muscles on T1 T2. diagnosis was made after exclusion all other possible pathologies. received prednisolone therapy; his improved, he discharged three days. Two weeks later, again ED same treated symptomatically. Conclusions This highlights very etiology for painful ophthalmoplegia, syndrome. Thickening images background ophthalmoplegia headache should raise clinician’s suspicion towards disease. In addition, causes important, as exclusion.</ns3:p>