DR. VIJAYA AGARWALLA

Dr. (Mrs.) BARUAH MAMONI

Abstract

A 47 years old female, previously healthy presented with severe headache & left sided periorbital pain for 3 weeks, drooping of left eyelid with limitation of eye movements for 1 week. O/E- left side complete ptosis with restriction of movement in all gazes & hypoaesthesia over left side of face was present. Her BCVA was 6/24 L/E & pupils were round,regular & reacting normally(Pupillary sparing). DIAGNOSIS- MRI showed enhancing soft tissue thickening along left cavernous sinus anteriorly extending into orbital apex without any filling defect in cavernous sinus or dilated SOV. AFTER DIAGNOSTIC WORK-UP & EXCLUDING ALL OTHER POSSIBILITIES, DIAGNOSIS OF TOLOSA HUNT SYNDROME WAS MADE. TREATMENT – Methylprednisolone 1g iv for 3days was given following which patient showed marked improvement in symptoms & signs. Steroid was then continued at a dose of 1mg/kg/day tapered over next 6weeks. After 2wks her BCVA was 6/6 with no ptosis & almost normal ocular movements.