Tolosa–Hunt syndrome: Difference between revisions
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[[File:Tolosa-hunt_ophtalmoplegia.jpg| | {{SI}} | ||
{{Infobox medical condition | |||
| name = Tolosa–Hunt syndrome | |||
| image = [[File:Tolosa-hunt_ophtalmoplegia.jpg|left|thumb|Tolosa–Hunt syndrome]] | |||
| caption = MRI showing Tolosa–Hunt syndrome | |||
| field = [[Neurology]] | |||
| symptoms = Severe [[headache]], [[ophthalmoplegia]], [[ptosis]], [[diplopia]], [[proptosis]] | |||
| complications = [[Vision loss]], [[chronic pain]] | |||
| onset = Sudden | |||
| duration = Weeks to months | |||
| types = | |||
| causes = [[Idiopathic]], [[inflammation]] of the [[cavernous sinus]] | |||
| risks = | |||
| diagnosis = [[Clinical diagnosis]], [[MRI]], [[CT scan]] | |||
| differential = [[Migraine]], [[cluster headache]], [[carotid-cavernous fistula]], [[cavernous sinus thrombosis]] | |||
| treatment = [[Corticosteroids]] | |||
| medication = [[Prednisone]] | |||
| prognosis = Good with treatment | |||
| frequency = Rare | |||
| deaths = | |||
}} | |||
'''Tolosa–Hunt syndrome''' ('''THS''') is a rare [[neurological disorder]] characterized by severe [[headache]] and [[ophthalmoplegia]] (paralysis or weakness of the eye muscles). The syndrome is named after [[Eduardo Tolosa]] and [[William Hunt]], who first described the condition in 1954 and 1961, respectively. | |||
==Presentation== | ==Presentation== | ||
Patients with Tolosa–Hunt syndrome typically present with a sudden onset of severe, unilateral [[periorbital pain]] that may be accompanied by [[cranial nerve]] palsies. The pain is often described as sharp or stabbing and can be debilitating. The affected cranial nerves usually include the [[oculomotor nerve]] (CN III), [[trochlear nerve]] (CN IV), and/or the [[abducens nerve]] (CN VI), leading to symptoms such as [[ptosis]], [[diplopia]], and restricted eye movements. | Patients with Tolosa–Hunt syndrome typically present with a sudden onset of severe, unilateral [[periorbital pain]] that may be accompanied by [[cranial nerve]] palsies. The pain is often described as sharp or stabbing and can be debilitating. The affected cranial nerves usually include the [[oculomotor nerve]] (CN III), [[trochlear nerve]] (CN IV), and/or the [[abducens nerve]] (CN VI), leading to symptoms such as [[ptosis]], [[diplopia]], and restricted eye movements. | ||
==Pathophysiology== | ==Pathophysiology== | ||
The exact cause of Tolosa–Hunt syndrome is not well understood, but it is believed to involve an inflammatory process in the [[cavernous sinus]] or the superior orbital fissure. This inflammation can lead to compression and damage of the cranial nerves passing through these structures. | The exact cause of Tolosa–Hunt syndrome is not well understood, but it is believed to involve an inflammatory process in the [[cavernous sinus]] or the superior orbital fissure. This inflammation can lead to compression and damage of the cranial nerves passing through these structures. | ||
==Diagnosis== | ==Diagnosis== | ||
The diagnosis of Tolosa–Hunt syndrome is primarily clinical, supported by imaging studies such as [[magnetic resonance imaging]] (MRI) or [[computed tomography]] (CT) scans. These imaging modalities may show signs of inflammation in the cavernous sinus or superior orbital fissure. [[Lumbar puncture]] and [[blood tests]] are often performed to rule out other causes of similar symptoms, such as [[infection]], [[neoplasm]], or [[autoimmune disease]]. | The diagnosis of Tolosa–Hunt syndrome is primarily clinical, supported by imaging studies such as [[magnetic resonance imaging]] (MRI) or [[computed tomography]] (CT) scans. These imaging modalities may show signs of inflammation in the cavernous sinus or superior orbital fissure. [[Lumbar puncture]] and [[blood tests]] are often performed to rule out other causes of similar symptoms, such as [[infection]], [[neoplasm]], or [[autoimmune disease]]. | ||
==Treatment== | ==Treatment== | ||
The mainstay of treatment for Tolosa–Hunt syndrome is high-dose [[corticosteroids]], which can lead to rapid improvement in symptoms. The typical course of treatment involves an initial high dose followed by a gradual tapering over several weeks. In some cases, other immunosuppressive agents may be used if corticosteroids are not effective or if the patient has contraindications to their use. | The mainstay of treatment for Tolosa–Hunt syndrome is high-dose [[corticosteroids]], which can lead to rapid improvement in symptoms. The typical course of treatment involves an initial high dose followed by a gradual tapering over several weeks. In some cases, other immunosuppressive agents may be used if corticosteroids are not effective or if the patient has contraindications to their use. | ||
==Prognosis== | ==Prognosis== | ||
The prognosis for patients with Tolosa–Hunt syndrome is generally good, with most patients experiencing significant relief of symptoms with appropriate treatment. However, recurrences can occur, and some patients may have residual deficits. | The prognosis for patients with Tolosa–Hunt syndrome is generally good, with most patients experiencing significant relief of symptoms with appropriate treatment. However, recurrences can occur, and some patients may have residual deficits. | ||
==See also== | |||
== | |||
* [[Cranial nerve]] | * [[Cranial nerve]] | ||
* [[Ophthalmoplegia]] | * [[Ophthalmoplegia]] | ||
| Line 24: | Line 39: | ||
* [[Computed tomography]] | * [[Computed tomography]] | ||
[[Category:Neurological disorders]] | [[Category:Neurological disorders]] | ||
[[Category:Headaches]] | [[Category:Headaches]] | ||
[[Category:Ophthalmology]] | [[Category:Ophthalmology]] | ||
[[Category:Inflammatory diseases]] | [[Category:Inflammatory diseases]] | ||
{{Neurology-stub}} | {{Neurology-stub}} | ||
Latest revision as of 19:17, 8 April 2025
Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD medical weight loss NYC and sleep center NYC
| Tolosa–Hunt syndrome | |
|---|---|
 | |
| Synonyms | N/A |
| Pronounce | N/A |
| Specialty | N/A |
| Symptoms | Severe headache, ophthalmoplegia, ptosis, diplopia, proptosis |
| Complications | Vision loss, chronic pain |
| Onset | Sudden |
| Duration | Weeks to months |
| Types | |
| Causes | Idiopathic, inflammation of the cavernous sinus |
| Risks | |
| Diagnosis | Clinical diagnosis, MRI, CT scan |
| Differential diagnosis | Migraine, cluster headache, carotid-cavernous fistula, cavernous sinus thrombosis |
| Prevention | N/A |
| Treatment | Corticosteroids |
| Medication | Prednisone |
| Prognosis | Good with treatment |
| Frequency | Rare |
| Deaths | |
Tolosa–Hunt syndrome (THS) is a rare neurological disorder characterized by severe headache and ophthalmoplegia (paralysis or weakness of the eye muscles). The syndrome is named after Eduardo Tolosa and William Hunt, who first described the condition in 1954 and 1961, respectively.
Presentation[edit]
Patients with Tolosa–Hunt syndrome typically present with a sudden onset of severe, unilateral periorbital pain that may be accompanied by cranial nerve palsies. The pain is often described as sharp or stabbing and can be debilitating. The affected cranial nerves usually include the oculomotor nerve (CN III), trochlear nerve (CN IV), and/or the abducens nerve (CN VI), leading to symptoms such as ptosis, diplopia, and restricted eye movements.
Pathophysiology[edit]
The exact cause of Tolosa–Hunt syndrome is not well understood, but it is believed to involve an inflammatory process in the cavernous sinus or the superior orbital fissure. This inflammation can lead to compression and damage of the cranial nerves passing through these structures.
Diagnosis[edit]
The diagnosis of Tolosa–Hunt syndrome is primarily clinical, supported by imaging studies such as magnetic resonance imaging (MRI) or computed tomography (CT) scans. These imaging modalities may show signs of inflammation in the cavernous sinus or superior orbital fissure. Lumbar puncture and blood tests are often performed to rule out other causes of similar symptoms, such as infection, neoplasm, or autoimmune disease.
Treatment[edit]
The mainstay of treatment for Tolosa–Hunt syndrome is high-dose corticosteroids, which can lead to rapid improvement in symptoms. The typical course of treatment involves an initial high dose followed by a gradual tapering over several weeks. In some cases, other immunosuppressive agents may be used if corticosteroids are not effective or if the patient has contraindications to their use.
Prognosis[edit]
The prognosis for patients with Tolosa–Hunt syndrome is generally good, with most patients experiencing significant relief of symptoms with appropriate treatment. However, recurrences can occur, and some patients may have residual deficits.
See also[edit]
- Cranial nerve
- Ophthalmoplegia
- Cavernous sinus
- Corticosteroids
- Magnetic resonance imaging
- Computed tomography
