The Radiological Evaluation of External Ophthalmoplegia: Tolosa-Hunt syndrome

Abstract

The Tolosa-Hunt syndrome is recurrent painful ophthalmoplegia due to nonspecific cavernous sinus inflammation. The documented incidence is one to two cases per million and bilaterality is even rarer. Delay in diagnosis might lead to permanent cranial nerve damage. Our purpose in this study is to discuss clinical and radiological features of the disease. We reported two patients whom presented with external ophthalmoplegia. The preliminary clinical diagnosis was ophthalmoplegic migraine. The primary radiological evaluation including cranial CT, cerebral angiography, magnetic resonance venography were all in normal limits. Finally MR imaging was performed which demonstrated the disease in the cavernous sinus region. We believe this article will serve not only to radiologists but a broad group of specialists including neurologists, otolaryngologists, internal medicine physicians dealing with cases of external ophthalmoplegia.

Keywords

• Tolosa-Hunt syndrome, MRI, ophthalmoplegia, cavernous sinus, CT

The Radiological Evaluation of External Ophthalmoplegia: Tolosa-Hunt syndrome

Abstract

Tolosa-Hunt sendromu kavernöz sinüsün spesifik olmayan enflamasyonuna bağlı olarak gelişen tekrarlayan ağrılı oftalmoplejidir. Görülme sıklığı milyonda bir veya iki vaka olarak belirtilirken bilateral görülmesi ise çok daha nadirdir. Tanıda olası gecikme kalıcı kraniyal sinir hasarına yol açabilir. Biz bu olgu sunumunda bu hastalığın klinik ve radyolojik özelliklerini tartışmayı hedefleyerek eksternal oftalmopleji ile prezente olan iki olgu sunmayı amaçladık. Klinik ön tanısı oftalmoplejik migren olan bu iki hastanın kraniyal bilgisayarlı tomografi, serebral anjiyografi ve manyetik rezonans venografiden oluşan radyolojik değerlendirilmesi normal sınırlardaydı. Hastaya son olarak çekilen kraniyal manyetik rezonans ile kavernöz sinüs bölgesinde hastalık gösterilerek tanı konuldu. Biz bu yazının sadece radyologlar için değil, eksternal oftalmopleji vakaları ile karşılaşabilen nöroloji, kulak burun boğaz ve dahiliye gibi bir çok uzmanlık dalı klinisyenleri için faydalı olacağını düşünmekteyiz

Keywords

• Tolosa-Hunt sendromu, MRG, oftalmopleji, Kavernöz sinüs, BT

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