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The Radiological Evaluation of External Ophthalmoplegia: Tolosa-Hunt syndrome

Yıl 2014, Cilt: 11 Sayı: 4, 285 - 289, 01.12.2014
https://doi.org/10.15197/sabad.1.11.89

Öz

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.

Kaynakça

  • Iaconetta G, Stella L, Esposito M, Cappabianca P. Tolosa- Hunt syndrome extending in the cerebellopontine angle. Cephalalgia 2005; 25:746-50.
  • Lachanas VA, Karatzias GT, Tsitiridis I, Panaras I, Sandris VG. Tolosa-Hunt syndrome misdiagnosed as sinusitis com- plication. J Otol and Laryngol 2008; 12:97-9.
  • Tolosa E. Periartritic lesions of the carotid siphon with the clinical features of a carotid infraclinoid aneurysm. J Neurol Neurosurg Psychiatry 1954; 17: 300-2.
  • Hunt WE, Meagher JN, LeFever HE, Zeman W. Painful ophthalmoplegia. Its relation to indolent inflammation of the cavernous sinus. Neurology 1961; 11:56-62.
  • Smith JL, Taxdal DSR. Painful ophthalmoplegia. The Tolosa-Hunt syndrome. Am J Opthalmol 1966; 61:1466-72.
  • Cakirer S. MRI findings in Tolosa-Hunt syndrome before and after systemic corticosteroid therapy. Eur J Radiol 2003; 45:83-90.
  • Kóbor J, Vörös E, Deák A. Magnetic resonance imaging in Tolosa-Hunt syndrome. Eur J Pediatr 2004; 163:753-4. 8. Headache
  • Classification Sub-Committee of the
  • International Headache Society. The International classi
  • fication of headache disorder, 2nd edn. Cephalalgia 2004; 24:1-160.
  • Tessitore E, Tesitore A. Tolosa-Hunt syndrome preceded by facial palsy. Headache 2000; 40:393-6.
  • Kwan ES, Wolpert SM, Hedges TR 3rd, Laucella M. Tolosa- Hunt syndrome revisited: not necessarily a diagnosis of exclusion. AJR Am J Roentgenol 1988; 150:413-8.
  • Aron-Rosa D, Doyon D, Salamon G, Michotey P. Tolosa- Hunt syndrome. Ann Ophthalmol 1978; 10: 1161-8.
  • Van Dalen JTW, Bleeker GM. The Tolosa-Hunt syndrome. Doc Ophthalmol 1977; 44:167-72.
  • Yousem DM, Atlas SW, Grossman RI, Sergott RC, Savino PJ, Bosley TM. MR imaging of Tolosa-Hunt syndrome. AJR Am J Roentgenol 1990; 154:167-70.
  • Odabaşi Z, Gökçil Z, Atilla S, Pabuşçu Y, Vural O, Yardim M. The value of MRI in a case of Tolosa-Hunt syndrome. Clin Neurol Neurosurg 1997; 99:151-4.
  • Polsky M, Janicki PC, Gunderson CH. Tolosa-Hunt syn- drome with sellar erosion. Ann Neurol 1979; 6:129-31.
  • Haque TL, Miki Y, Kashii S, et al. Dynamic MR imaging in Tolosa-Hunt syndrome. Eur J Radiol 2004; 51:209-17.
  • Hannerz J, Ericson K, Bergstrand G. Orbital phlebotog- raphy in patients with Tolosa-Hunts’s syndrome in com- parison with normal subjects. Acta Radiol Diagn 1984; 25:457-63.
  • Aktan S, Aykut C, Erzen C. Computed tomography and magnetic resonance imaging in three patients with Tolosa-Hunt syndrome. Eur Neurol 1993; 33:393-6.
  • Jain R, Sawhney S, Koul RL, Chand P. Tolosa-Hunt syn- drome: MRI appearances. J Med Imaging Radiat Oncol 2008; 52:447-51.
  • Bosch J, Ortega-Aznar A, Tintore M et al. Hypertrophic pachymeningitis. A review of the histories of two cases and pathological relationship with the Tolosa-Hunt syn- drome and the orbital pseudotumor. Rev Neurol 2000; 3:946-51.
  • Zournas C, Trakadas S, Kapaki E, et al. Gadopentetate dimeglumine-enhanced MR in the diagnosis of the Tolosa- Hunt syndrome. AJNR Am J Neuroradiol 1995; 16:942-4.
  • Ozawa T, Minakawa T, Saito A, Yoneoka Y, Yoshiruma J, Arai H. MRA demonstration of ‘Periarteritis’ in Tolosa- Hunt syndrome. Acta Neurochir (Wien) 2001;143:309-12.
  • Kline LB, Hoyt WF. The Tolosa-Hunt syndrome. J Neurol Neurosurg Psychiatry 2001; 71:577-82.

The Radiological Evaluation of External Ophthalmoplegia: Tolosa-Hunt syndrome

Yıl 2014, Cilt: 11 Sayı: 4, 285 - 289, 01.12.2014
https://doi.org/10.15197/sabad.1.11.89

Öz

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

Kaynakça

  • Iaconetta G, Stella L, Esposito M, Cappabianca P. Tolosa- Hunt syndrome extending in the cerebellopontine angle. Cephalalgia 2005; 25:746-50.
  • Lachanas VA, Karatzias GT, Tsitiridis I, Panaras I, Sandris VG. Tolosa-Hunt syndrome misdiagnosed as sinusitis com- plication. J Otol and Laryngol 2008; 12:97-9.
  • Tolosa E. Periartritic lesions of the carotid siphon with the clinical features of a carotid infraclinoid aneurysm. J Neurol Neurosurg Psychiatry 1954; 17: 300-2.
  • Hunt WE, Meagher JN, LeFever HE, Zeman W. Painful ophthalmoplegia. Its relation to indolent inflammation of the cavernous sinus. Neurology 1961; 11:56-62.
  • Smith JL, Taxdal DSR. Painful ophthalmoplegia. The Tolosa-Hunt syndrome. Am J Opthalmol 1966; 61:1466-72.
  • Cakirer S. MRI findings in Tolosa-Hunt syndrome before and after systemic corticosteroid therapy. Eur J Radiol 2003; 45:83-90.
  • Kóbor J, Vörös E, Deák A. Magnetic resonance imaging in Tolosa-Hunt syndrome. Eur J Pediatr 2004; 163:753-4. 8. Headache
  • Classification Sub-Committee of the
  • International Headache Society. The International classi
  • fication of headache disorder, 2nd edn. Cephalalgia 2004; 24:1-160.
  • Tessitore E, Tesitore A. Tolosa-Hunt syndrome preceded by facial palsy. Headache 2000; 40:393-6.
  • Kwan ES, Wolpert SM, Hedges TR 3rd, Laucella M. Tolosa- Hunt syndrome revisited: not necessarily a diagnosis of exclusion. AJR Am J Roentgenol 1988; 150:413-8.
  • Aron-Rosa D, Doyon D, Salamon G, Michotey P. Tolosa- Hunt syndrome. Ann Ophthalmol 1978; 10: 1161-8.
  • Van Dalen JTW, Bleeker GM. The Tolosa-Hunt syndrome. Doc Ophthalmol 1977; 44:167-72.
  • Yousem DM, Atlas SW, Grossman RI, Sergott RC, Savino PJ, Bosley TM. MR imaging of Tolosa-Hunt syndrome. AJR Am J Roentgenol 1990; 154:167-70.
  • Odabaşi Z, Gökçil Z, Atilla S, Pabuşçu Y, Vural O, Yardim M. The value of MRI in a case of Tolosa-Hunt syndrome. Clin Neurol Neurosurg 1997; 99:151-4.
  • Polsky M, Janicki PC, Gunderson CH. Tolosa-Hunt syn- drome with sellar erosion. Ann Neurol 1979; 6:129-31.
  • Haque TL, Miki Y, Kashii S, et al. Dynamic MR imaging in Tolosa-Hunt syndrome. Eur J Radiol 2004; 51:209-17.
  • Hannerz J, Ericson K, Bergstrand G. Orbital phlebotog- raphy in patients with Tolosa-Hunts’s syndrome in com- parison with normal subjects. Acta Radiol Diagn 1984; 25:457-63.
  • Aktan S, Aykut C, Erzen C. Computed tomography and magnetic resonance imaging in three patients with Tolosa-Hunt syndrome. Eur Neurol 1993; 33:393-6.
  • Jain R, Sawhney S, Koul RL, Chand P. Tolosa-Hunt syn- drome: MRI appearances. J Med Imaging Radiat Oncol 2008; 52:447-51.
  • Bosch J, Ortega-Aznar A, Tintore M et al. Hypertrophic pachymeningitis. A review of the histories of two cases and pathological relationship with the Tolosa-Hunt syn- drome and the orbital pseudotumor. Rev Neurol 2000; 3:946-51.
  • Zournas C, Trakadas S, Kapaki E, et al. Gadopentetate dimeglumine-enhanced MR in the diagnosis of the Tolosa- Hunt syndrome. AJNR Am J Neuroradiol 1995; 16:942-4.
  • Ozawa T, Minakawa T, Saito A, Yoneoka Y, Yoshiruma J, Arai H. MRA demonstration of ‘Periarteritis’ in Tolosa- Hunt syndrome. Acta Neurochir (Wien) 2001;143:309-12.
  • Kline LB, Hoyt WF. The Tolosa-Hunt syndrome. J Neurol Neurosurg Psychiatry 2001; 71:577-82.
Toplam 25 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Bölüm Olgu Sunumu
Yazarlar

Hatice Gul Hatipoglu Bu kişi benim

Hasan Ali Durmaz Bu kişi benim

Onur Ergun Bu kişi benim

Semra Duran Bu kişi benim

Mehtap Cavusoglu Bu kişi benim

Deniz Ciliz Bu kişi benim

Enis Yuksel Bu kişi benim

Yayımlanma Tarihi 1 Aralık 2014
Yayımlandığı Sayı Yıl 2014 Cilt: 11 Sayı: 4

Kaynak Göster

APA Hatipoglu, H. G., Durmaz, H. A., Ergun, O., Duran, S., vd. (2014). The Radiological Evaluation of External Ophthalmoplegia: Tolosa-Hunt syndrome. European Journal of General Medicine, 11(4), 285-289. https://doi.org/10.15197/sabad.1.11.89
AMA Hatipoglu HG, Durmaz HA, Ergun O, Duran S, Cavusoglu M, Ciliz D, Yuksel E. The Radiological Evaluation of External Ophthalmoplegia: Tolosa-Hunt syndrome. European Journal of General Medicine. Aralık 2014;11(4):285-289. doi:10.15197/sabad.1.11.89
Chicago Hatipoglu, Hatice Gul, Hasan Ali Durmaz, Onur Ergun, Semra Duran, Mehtap Cavusoglu, Deniz Ciliz, ve Enis Yuksel. “The Radiological Evaluation of External Ophthalmoplegia: Tolosa-Hunt Syndrome”. European Journal of General Medicine 11, sy. 4 (Aralık 2014): 285-89. https://doi.org/10.15197/sabad.1.11.89.
EndNote Hatipoglu HG, Durmaz HA, Ergun O, Duran S, Cavusoglu M, Ciliz D, Yuksel E (01 Aralık 2014) The Radiological Evaluation of External Ophthalmoplegia: Tolosa-Hunt syndrome. European Journal of General Medicine 11 4 285–289.
IEEE H. G. Hatipoglu, H. A. Durmaz, O. Ergun, S. Duran, M. Cavusoglu, D. Ciliz, ve E. Yuksel, “The Radiological Evaluation of External Ophthalmoplegia: Tolosa-Hunt syndrome”, European Journal of General Medicine, c. 11, sy. 4, ss. 285–289, 2014, doi: 10.15197/sabad.1.11.89.
ISNAD Hatipoglu, Hatice Gul vd. “The Radiological Evaluation of External Ophthalmoplegia: Tolosa-Hunt Syndrome”. European Journal of General Medicine 11/4 (Aralık 2014), 285-289. https://doi.org/10.15197/sabad.1.11.89.
JAMA Hatipoglu HG, Durmaz HA, Ergun O, Duran S, Cavusoglu M, Ciliz D, Yuksel E. The Radiological Evaluation of External Ophthalmoplegia: Tolosa-Hunt syndrome. European Journal of General Medicine. 2014;11:285–289.
MLA Hatipoglu, Hatice Gul vd. “The Radiological Evaluation of External Ophthalmoplegia: Tolosa-Hunt Syndrome”. European Journal of General Medicine, c. 11, sy. 4, 2014, ss. 285-9, doi:10.15197/sabad.1.11.89.
Vancouver Hatipoglu HG, Durmaz HA, Ergun O, Duran S, Cavusoglu M, Ciliz D, Yuksel E. The Radiological Evaluation of External Ophthalmoplegia: Tolosa-Hunt syndrome. European Journal of General Medicine. 2014;11(4):285-9.