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Recurrent Tolosa-Hunt syndrome
1Neurological Clinics, Karolinska Hospital, Stockholm, Sweden.
Cephalalgia : an International Journal of Headache
|February 1, 1992
Summary
Recurrent Tolosa-Hunt syndrome shares systemic symptoms with orbital venous vasculitis, suggesting a link. Steroid treatment was effective, with azathioprine managing chronic pain.
Area of Science:
- Neurology
- Ophthalmology
- Rheumatology
Background:
- Tolosa-Hunt syndrome (THS) is a rare condition characterized by painful ophthalmoplegia.
- Recurrent cases and associated systemic symptoms require further investigation.
Purpose of the Study:
- To investigate the clinical characteristics and potential underlying mechanisms of recurrent Tolosa-Hunt syndrome.
- To explore the relationship between THS and orbital venous vasculitis.
Main Methods:
- Study of twenty consecutive patients with recurrent THS.
- Clinical evaluation including assessment of systemic symptoms and cranial nerve involvement.
- Orbital phlebography was performed in most patients.
- Treatment response to steroids and azathioprine was documented.
Main Results:
- One patient had a family history of THS.
- 33% experienced recurrent unilateral periorbital pain without ophthalmoplegia.
- Systemic symptoms similar to orbital venous vasculitis were observed.
- 73% showed abnormal orbital phlebograms.
- Steroid treatment yielded prompt responses; azathioprine managed chronic pain.
Conclusions:
- Recurrent THS may be associated with systemic inflammatory conditions like orbital venous vasculitis.
- Orbital phlebography can be a useful diagnostic tool.
- Steroids are effective for acute episodes, and azathioprine may help in chronic cases.