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Tolosa–Hunt syndrome misdiagnosed as sinusitis complication

Published online by Cambridge University Press:  16 January 2008

V A Lachanas ,
G T Karatzias ,
I Tsitiridis ,
I Panaras  and
V G Sandris
V A Lachanas
Affiliation:
Department of Otolaryngology, General Hospital of Larissa, Larissa, Greece
G T Karatzias*
Affiliation:
Department of Otolaryngology, General Hospital of Larissa, Larissa, Greece
I Tsitiridis
Affiliation:
Department of Otolaryngology, General Hospital of Larissa, Larissa, Greece
I Panaras
Affiliation:
Department of Otolaryngology, General Hospital of Larissa, Larissa, Greece
V G Sandris
Affiliation:
Department of Otolaryngology, General Hospital of Larissa, Larissa, Greece
*
Address for correspondence: Dr George T Karatzias, Consultant, 4 Skra Str, 41221 Larissa, Greece. Fax: +30 2410615466 E-mail: [email protected]
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Abstract

Objective:

Tolosa–Hunt syndrome is a rare condition of painful ophthalmoplegia combined with ipsilateral ocular motor nerve palsies, caused by non-specific granulomatous inflammation in the cavernous sinus, superior orbital fissure or orbit. A case of Tolosa–Hunt syndrome misdiagnosed as sinusitis orbital complication is reported.

Case report:

A patient suffering from left periorbital pain, upper eyelid oedema and ptosis, and horizontal diplopia, diagnosed as sinusitis orbital complication, was referred to our department. Clinical evaluation revealed only a left VIth nerve paresis. Haematological studies, cerebrospinal fluid tests and computed tomography scanning were negative. A magnetic resonance imaging (MRI) scan showed enhancement of the left cavernous sinus. Corticosteroid therapy was commenced, and within three days all symptoms disappeared. A diagnosis of Tolosa–Hunt syndrome was made. Follow-up MRI studies were normal.

Conclusion:

Tolosa–Hunt syndrome, although rare, is a nosological entity that otolaryngologists must bear in mind. Magnetic resonance imaging studies are essential in the diagnosis and follow up of these patients, in order to avoid a mistaken Tolosa–Hunt syndrome diagnosis.

Keywords

Tolosa-Hunt SyndromeSinusitis
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 122 , Issue 1 , January 2008 , pp. 97 - 99
Copyright
Copyright © JLO (1984) Limited 2006

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References

1Kobor, J, Voros, E, Deak, A. Magnetic resonance imaging in Tolosa-Hunt syndrome. Eur J Pediatr 2004;163:753–4CrossRefGoogle ScholarPubMed
2Iaconetta, G, Stella, L, Esposito, M, Cappabianca, P. Tolosa-Hunt syndrome extending in the cerebello-pontine angle. Cephalalgia 2005;25:746–50CrossRefGoogle ScholarPubMed
3Cakirer, S. MRI findings in the patients with the presumptive clinical diagnosis of Tolosa-Hunt syndrome. Eur Radiol 2003;13:17–28CrossRefGoogle Scholar
4Kline, LB, Hoyt, WF. The Tolosa-Hunt syndrome. J Neurol Neurosurg Psychiatry 2001;71:577–82CrossRefGoogle ScholarPubMed
5Headache Classification Sub-Committee of the International Headache Society. The international classification of headache disorder, 2nd edn.Cephalalgia 2004;24:1–160Google Scholar
6Haque, TL, Miki, Y, Kashii, S, Yamamoto, A, Kanagaki, M, Takahashi, T et al. Dynamic MR imaging in Tolosa-Hunt syndrome. Eur J Radiol 2004;51:209–17CrossRefGoogle ScholarPubMed
7Cakirer, S. MRI findings in Tolosa-Hunt syndrome before and after systemic corticosteroid therapy. Eur J Radiol 2003;45:83–90CrossRefGoogle ScholarPubMed
8Odabasi, Z, Gokcil, Z, Atilla, S, Pabuscu, Y, Vural, O, Yardim, M. The value of MRI in a case of Tolosa-Hunt syndrome. Clin Neurol Neurosurg 1997;99:151–4CrossRefGoogle Scholar
9Zournas, C, Trakadas, S, Kapaki, E, Doris, S, Gatzonis, S, Gouliamos, A et al. Gadopentetate dimeglumine-enhanced MR in the diagnosis of the Tolosa-Hunt syndrome. Am J Neuroradiol 1995;16(suppl 4):942–4Google ScholarPubMed