Idiopathic Tolosa-Hunt syndrome: four additional cases
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Updated: Jul 2, 2026

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Published on: August 20, 2019
D Kirbas1, B Topcular, M E Ozcan
1Bakirkoy Prof. Dr. Mazhar Osman Training and Research Hospital for Mental Health and Neurological Diseases, Istanbul. btopcular@gmail.com
Abstract:
Idiopathic Tolosa-Hunt syndrome (ITHS) is a very rare cause of painful ophthalmoplegia characterized by unilateral orbital pain, ipsilateral oculomotor paralysis and prompt response to steroids. In this paper we report 4 additional cases of ITHS. This rare cause of painful ophthalmoplegia effects the cranial nerves due to a granulomatous lesion of unknown etiology in the cavernous sinus or superior orbital fissure. The International Headache Society redefined the diagnostic criteria for ITHS but it is still mostly a diagnosis of exclusion. Careful evaluation and follow-up is essential for diagnosis. Optimal therapy duration and dosage and prophylactic treatment in recurrent cases needs further research.
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