DR. KSHEERAJA Y

Dr.Ananth Bhandary, Dr. MANASAVEENA N T

Abstract

INTRODUCTION: Tolosa-hunt syndrome is a rare condition with annual incidence of 1 case per million.Its described as severe , unilateral periorbital headache associated with painful ophthalmoplegia

CASE REPORT:A 75 year old male patient,after uneventful right eye cataract surgery operated a month back ,presented With complaints of severe pain in the left eye, left hemicranial headache.Had left eye vision-6/36, ptosis,restricted elevation,depression,adduction.MRI brain showed left sided homogenous enhancement of thickened cavernous dura

MANAGEMENT:oral Prednisolone 1mg/kg body wt for 5 days then gradual tapered over month

RESULT:Pain relived by 5 days and complete recovery of ptosis and extraocular movements by the end of 1month

CONCLUSION:

Tolosa hunt syndrome should be considered for severe periorbital pain ,oculomotor nerve palsy,painful ophthalmoplegia

Thorough neurological examination, imaging will help in diagnosis and gives dramatic response with oral steroids if given timely