Tolosa-Hunt Syndrome: A Case Report

Tolosa-Hunt syndrome is the painful ophthalmoplegia that is located in the anterior cavernous sinuses, superior orbital fissure and orbital apex with unknown etiology. Clinical findings include unilateral orbital pain associated with paralysis of one or more of the third, fourth and sixth cranial nerves. In addition to the involvement of the ocular motor nerves, ophthalmic and maxillary branches of the fifth cranial nerve may be affected. Cranial magnetic resonance imaging reveals enlargement of the affected cavernous sinus by an abnormal tissue isointense with gray matter on T1-weighted images and iso-hypointense on T2-weighted images. This abnormal tissue markedly increases in signal intensity after contrast injection.