Tolosa-Hunt syndrome: a case with associated facial nerve palsy

A 54-year-old man developed a painful right third nerve palsy with signs of involvement of the first two divisions of the trigeminal nerve and, later, ipsilateral peripheral facial nerve weakness. A cavernous sinus venogram demonstrated narrowing of the third portion of the right ophthalmic vein and poor filling of the adjacent cavernous sinus. Resolution occurred with steroid therapy. The Tolosa-Hunt syndrome may be a variant of a larger syndrome of recurrent multiple cranial polyneuropathies without identifiable cause.