Copyright 2017 The Korean Society of Neuro-Ophthalmology http://neuro-ophthalmology.co.kr S47 ISSN: 2234-0971
Rapid Spontaneous Remission of Tolosa-Hunt Syndrome
Shin Yeop Kim, Jae-Han Park
Department of Neurology, Catholic University of Daegu, School of Medicine, Daegu, Korea
Background: Tolosa-Hunt syndrome is defined as unilateral painful ophthalmoplegia due to non-specific granulomatous inflam- mation involving the cavernous sinus or the orbital apex and orbit.
Case report: A 45-year-old man visited our emergency department with painful ophthalmoplegia of right eye. Right frontal and periocular pain was developed 1 days ago. Neuro-ophthalmologic examination demonstrated isolated complete oculomotor nerve palsy of the right eye. Brain magnetic resonance image showed irregular wall thickening with enhancement in the lateral wall of right cavernous sinus suggesting granulomatous inflammation compatible to Tolosa-Hunt syndrome. The ocular pain and ophthalmolegia resolved over 5 days without specific treatment such as steroid. If painful ophthalmoplegia improved rapidly without streoid treatment, other etiologies such as unruptured internal carotid artery aneurysm should be considered. But, he didn’t showed any abnormalities on cerebral angiography.
Conclusion: The Tolosa-Hunt syndrome may show spontaneous remission but this rapid remission was not reported as far as we know. We experienced a case of rapid spontaneous remission in Tolosa-Hunt syndrome without steroid treatment.
대한안신경의학회지: 제7권 Supplement 1 Clin Neuroophthalmol 7(Suppl 1):S47-47, May 2017