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[Tolosa-Hunt syndrome].

L V Reznikova1, M B Kuchminskaya1, L V Sherstneva1

  • 1I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.

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|December 23, 2025
PubMed
Summary

Tolosa-Hunt syndrome (THS) is a rare neuro-ophthalmological condition causing painful eye movement issues due to inflammation. Early diagnosis and glucocorticoid treatment are crucial to prevent vision loss and permanent ocular motor deficits.

Keywords:
Tolosa—Hunt syndromecavernous sinusglucocorticosteroidsgranulomatous inflammationneuroimagingophthalmoplegia

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Area of Science:

  • Neuro-ophthalmology
  • Neurology
  • Inflammatory diseases

Background:

  • Tolosa-Hunt syndrome (THS) is a rare condition characterized by granulomatous inflammation in the cavernous sinus.
  • It affects cranial nerves III, IV, and VI, leading to painful ophthalmoplegia and ocular motility restrictions.
  • THS can also involve branches of the V nerve and oculosympathetic fibers.

Purpose of the Study:

  • To review current data on Tolosa-Hunt syndrome.
  • To emphasize clinical presentation, diagnostic criteria, and treatment methods.
  • To highlight the importance of differential diagnosis and timely intervention.

Main Methods:

  • Literature review of current data on Tolosa-Hunt syndrome.
  • Analysis of clinical presentation, diagnostic challenges, and therapeutic strategies.
  • Emphasis on differential diagnosis from conditions like brain tumors and aneurysms.

Main Results:

  • THS presents with painful ocular motility restrictions and ophthalmoplegia due to cranial nerve lesions.
  • Accurate diagnosis is challenging, requiring differentiation from other cavernous sinus pathologies.
  • Glucocorticoid therapy is the primary treatment, aiming to resolve inflammation.

Conclusions:

  • Timely diagnosis and treatment of THS are essential.
  • Early glucocorticoid administration can prevent severe complications such as vision loss.
  • Distinguishing THS from mimics like tumors and aneurysms is critical for effective management.