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.

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

Issue

Section

CASE REPORT