Clinical presentation and management of Tolosa-Hunt syndrome: a case report Authors Bisma Qasim Department of Ophthalmology and Visual Sciences, Dow University of Health Sciences, Karachi, Pakistan Farnaz Siddiqui Department of Ophthalmology and Visual Sciences, Dow University of Health Sciences, Karachi, Pakistan Maria Saleem Department of Ophthalmology and Visual Sciences, Dow University of Health Sciences, Karachi, Pakistan Muhammad Zohaib Fourth Year MBBS Student, Dow International Medical College, Dow University of Health Sciences, Karachi, Pakistan Muhammad Khuzzaim Khan Fourth Year MBBS Student, Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan Nisar Ahmed Siyal Department of Ophthalmology and Visual Sciences, Dow University of Health Sciences, Karachi, Pakistan DOI: https://doi.org/10.47391/JPMA.10593 Keywords: chemosis, ophthalmoplegia, cavernous sinus Abstract Tolosa-Hunt Syndrome (THS) is an exceptionally rare disorder characterised by recurrent episodes of excruciating ophthalmoplegia, commonly affecting one side of the face and involving the third, fourth, sixth, and fifth cranial nerves. This syndrome results from non-specific inflammation affecting the cavernous sinus, superior orbital fissure (SOF), and/or orbital apex. In this case report, we present the clinical features, diagnostic evaluation, and management of a 46-year-old female with THS. The patient initially presented with right-sided peri-orbital pain, swelling, chemosis, and headache. Ocular examination revealed mild to moderate proptosis, complete ophthalmoplegia, and normal findings in the left eye. Imaging studies, including CT and contrast-enhanced MRI, confirmed the presence of non-specific inflammation in the cavernous sinus and associated structures. Immediate treatment with oral Prednisolone led to a significant reduction in symptoms within five days, with complete resolution of chemosis and pain. Ocular movements gradually improved over the following week. Long-term follow-up showed no recurrence of symptoms. Keywords: Chemosis; Ophthalmoplegia; Cavernous Sinus. Downloads Full Text Article Published 2024-12-23 How to Cite Bisma Qasim, Farnaz Siddiqui, Maria Saleem, Muhammad Zohaib, Muhammad Khuzzaim Khan, & Nisar Ahmed Siyal. (2024). Clinical presentation and management of Tolosa-Hunt syndrome: a case report. Journal of the Pakistan Medical Association, 75(1), 115–118. https://doi.org/10.47391/JPMA.10593 More Citation Formats ACM ACS APA ABNT Chicago Harvard IEEE MLA Turabian Vancouver Download Citation Endnote/Zotero/Mendeley (RIS) BibTeX Issue Vol. 75 No. 1 (2025): JANUARY Section CASE REPORT License Copyright (c) 2024 Journal of the Pakistan Medical Association This work is licensed under a Creative Commons Attribution 4.0 International License.