[A case of painful bilateral ophthalmoplegia]

The authors present a case of Tolosa-Hunt syndrome with the particularity of a simultaneous palsy of both oculomotor nerves. The evolution is followed during 16 years. The clinical description, the criteria of the syndrome and the differential diagnosis are discussed. The diagnosis is based on the clinical evolution, the transitory palsy of the oculomotor nerves and the involvement of the optic nerve. The response on steroid treatment was spectacular. Bilateral and fluctuant oculomotor palsy is possible in the TolosaHunt syndrome. General investigations are mandatory to exclude other pathologies.