Diagnosis and Management of a Patient with Tolasa-Hunt Syndrome

مقدمه/ بیان مساله : Tolosa-Hunt syndrome characterized by severe hemicranial headache and painful eye movement. Its cause is chronic idiopathic inflammation in the cavernous sinus or superior orbital fissure. It can lead to symptoms such as ptosis, diplopia, other forms of ophthalmoplegia and neuropathy in the other cranialnerves. In this case report, we present a middle-aged man with a history of sudden-onset severe unilateral headache followed by blurred vision with a diagnosis of Tulosa-Hunt syndrome.معرفی بیمار : A ۴۳-year-old man without underlying disease in past medical history presented to the emergency department of the hospital with an abrupt-onset severe unilateral headache on three days before admission. Shortly after his headache, diplopia, and blurred vision occurred. Upon physical examination he had ptosis, Cranial nerve palsy (۳,۴,۶), erythema, and periorbital edema in left eye. Other neurologic examinations and systemic examinations were normal. his vital sign was stable and had no fever. Initially, antibiotics and anticoagulants were started for the patient with suspicion of orbital cellulitis or sinovenous thrombosis (CSVT). All the blood tests performed for the patient included complete blood count, biochemical, inflammatory and rheumatological tests were normal. In the imaging evaluations including magnetic resonance imaging(MRI) of the orbit and brain, magnetic resonance venography and angiography, no explanation was found for the patients symptoms. According to the ophthalmologists opinion, with a possible suspicion of Tolosa-Hunt syndrome, prednisolone was started with a daily dose of ۵۰ mg. Within a week, the patient had a definite clinical response to the treatment, and the patients symptoms improved significantly. Within a month, the patients corticosteroid dose was tapered and stopped, and the symptoms of patient disappeared completely.

کلیدواژه ها:

Tolosa-Hunt Syndrome ، Chronic Inflammation ، Corticosteroids