Document Detail


Serial neuroimaging in tolosa-hunt syndrome with acute bilateral complete ophthalmoplegia.
MedLine Citation:
PMID:  19453827     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Tolosa-Hunt syndrome (THS) is a very rare, relapsing, and remitting painful ophthalmoplegia caused by nonspecific granulomatous inflammation in the cavernous sinus. To our knowledge, bilateral complete, simultaneous palsies of all 3 cranial nerves associated with extraocular movement have not been reported. We describe the first such patient with bilateral THS that responded quickly to corticosteroid therapy. A 54-year-old man presented with a periorbital and frontal headache with acute bilateral severe blepharoptosis and fixed eyes, which dramatically responded to corticosteroid therapy. He had diabetes mellitus type II. Brain MRI showed granulomatous inflammation in both cavernous sinuses and thickening of the surrounding dura mater of the cranial base, suggesting the coexistence of focal hypertrophic cranial pachymeningitis. Our experience indicates that steroid therapy with strict control of blood sugar should be considered in patients with THS complicated by diabetes. MRI is a valuable tool for serially monitoring the response of lesions to treatment in THS.
Authors:
Kazuma Sugie; Masami Morikawa; Toshiaki Taoka; Makito Hirano; Satoshi Ueno
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of neuroimaging : official journal of the American Society of Neuroimaging     Volume:  21     ISSN:  1552-6569     ISO Abbreviation:  J Neuroimaging     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2011-01-04     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9102705     Medline TA:  J Neuroimaging     Country:  United States    
Other Details:
Languages:  eng     Pagination:  79-82     Citation Subset:  IM    
Copyright Information:
Copyright © 2009 by the American Society of Neuroimaging.
Affiliation:
From the Department of Neurology (KS, MM, MH, SU) and the Department of Radiology (TT), Nara Medical University School of Medicine, Nara, Japan.
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