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Query: UMLS:C0029089 (ophthalmoplegia)
 3,338 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The authors begin by enumerating the various syndromes in which painful ophthalmoplegia may be observed (sphenoidal fissure syndrome, Collier's syndrome, syndromes involving the orbital apex, the cavernous sinus and parasellar syndromes; Raeder's syndrome, Gradenigo's syndrome and Fischer-Brugge syndrome). They then discuss the various causes that must be investigated in all cases of painful ophtalmoplegia. They consider in order: -- ophtalmoplegia due to general causes (especially diabetes) and neurological causes (e.g. multiple sclerosis); -- ophtalmoplegia due to common local canses space-occupying processes, vascular malformations, ear, nose and larynx infections); -- painful ophalmoplegia of unknown origin, which includes four entities of very differing importance (Gubler and Charcot's ophthalmoplegic migraine and Tolosa-Hunt syndrome of which the clinical symptoms and course are so different that they can be distinguished as two entities; and, secondarily, inflammatory pseudo-tumours of the orbit and the recurrent multiple cranial nerve palsies that are observed in South-East Asia). (Acta nurol. belg., 1977, 77, 331-350).
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PMID:[Painful ophthalmoplegia (author's transl)]. 2 45

Twenty-six patients with painful ophthalmoplegia were classified as having the Tolosa-Hunt syndrome on the basis of their clinical findings and response to steroid therapy. All patients underwent orbital venography, a review of which forms the contents of this investigation. Orbital venography, a review of which forms the contents of this investigation. Orbital venograms were normal in 16 patients and abnormal in 10. The major abnormalities were (1) obstruction of the superior ophthalmic vein in its third segment without displacement; (2) collateral venous flow through small venous channels or collateral veins; and (3) poor opacification of the ipsilateral cavernous sinus.
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PMID:Orbital venography in painful ophthalmoplegia (Tolosa-Hunt syndrome). 11 66

This paper reports 2 cases of the Tolosa-Hunt Syndrome and reviews 70 other cases reported in the literature. Common findings of this syndrome are the recurring painful ophthalmoplegia affecting the 3rd, 4th and 6th cranial nerve, as well as the first branch of the 5th and the optic nerve. No ethiologic factor has so far been found, but is regarded as a non specific inflammation in the area of the sinus cavernosus and adjacent orbital bone. Residual defects in about one third of affected persons is the normal course of the disease. Early diagnosis and initiation of steroid therapy results in quick relief of pain and may influence prognosis.
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PMID:[The Tolosa-Hunt syndrome (author's transl)]. 24 44

Seven patients with remittent painful ophthalmoplegia for which no specific local cause was found were seen during a period of five years. One had coincidental rheumatoid arthritis, and another had actinomycosis of the ipsilateral middle ear and contralateral parotid gland. The other five had no evidence of generalised autoimmune disease nor any other systemic disorder, two having separate episodes affecting each side. A history of relapsing and remitting painful ophthalmoplegia is suggestive of the Tolosa-Hunt syndrome, but it is rarely possible to confirm that the lesion in the cavernous sinus is the result of non-specific granulomatous infiltration so that the diagnosis remains one of exclusion. Carotid arteriography may show narrowing of the intracavernous part of the internal carotid artery. Orbital venography may also be helpful, particularly when the carotid arteriogram is normal. We believe that the Tolosa-Hunt syndrome is more common in England than is generally realised, but that its clinical features do not necessarily indicate a single pathological entity. Its recognition is important since the response to steroids, although not specific, is rapid in most patients, and the prognosis for complete recovery is relatively good.
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PMID:Remittent painful ophthalmoplegia: the Tolosa-Hunt syndrome? A report of seven cases and review of the literature. 43 37

Diagnosis of Tolosa-Hunt syndrome was made in a 25-year-old woman on the basis of unilateral third and sixth nerve paresis and possible involvement of the first branch of the ipsilateral trigeminal nerve, accompanied by headaches and ocular pain, which responded promptly to corticosteroid administration. Irregular narrowing of the right carotid siphon and occlusion of the homolateral superior ophthalmic vein were observed. During steroid therapy this stenosis improved in association with almost complete clinical recovery, although the vein was not recanalized. Of ten reported cases with contrast radiographic abnormalities, including our own, only two showed pupillary involvement. We hypothesize that the third nerve paresis with pupillary sparing in this syndrome may be attributable to the same underlying mechanism as that of diabetic ophthalmoplegia.
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PMID:Tolosa-Hunt syndrome. Arteriographic evidence of improvement in carotid narrowing. 63 55

Ten cases of painful ophthalmoplegia are reported. In all cases pain marked the onset of the disease; the condition was mostly unilateral. Recurrence and dramatic response to steroid therapy were more constant features than angiographic findings which may be completely normal. CAT permitted us to eliminate a tumor of the cavernous sinus in 7 cases, but in one case, which was operated, an aggravation followed surgery. Despite complete investigations of all patients, some questions remain unanswered. Is it an inflammatory or an allergic inflammatory process? (And the presence of antinuclear factor in an only case does not permit it to respond.) Why is the process confined to the superior orbital fissure? Mathew and Chandy tried to find a similarity between this syndrome and Bell's palsy although the 2 syndromes have not been shown to coexist. Is the Tolosa-Hunt syndrome comparable to the pseudotumor of the orbit? Although the dura mater is inserted on the border of the sphenoidal cleft, some patients may altern the 2 syndromes.
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PMID:Tolosa-Hunt syndrome. 73 3

The Tolosa-Hunt Syndrome consists of intermittent painful ophthalmoplegia resulting from a non-specific inflammatory process in the cavernous sinus and superior orbital fissure, which responds to steroid therapy. We report two additional cases to the literature of the Tolosa-Hunt Syndrome and we are interested in pointing out the importance of orbital venography in the diagnosis of this syndrome. Orbital venography demonstrates the partial occupation of the cavernous sinus and the lack of visualization of the 3rd segment of the superior ophthalmic vein.
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PMID:The tolosa-hunt syndrome: report of two cases. 98 Jan 97

Two cases of painful ophthalmoplegia are described which were initially thought to be examples of the Tolosa-Hunt syndrome. Both were partially responsive to steroid treatment. Subsequent investigations showed that in one case the condition was due to an aneurysm and in the other to a malignant lymphoma.
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PMID:Tolosa-Hunt syndrome. The dangers of an eponym. 113 55

The diagnosis of Tolosa-Hunt syndrome should be suspected in the presence of recurrent "painful ophthalmoplegia." The most useful tests are the rapid (within 48 hours) response to steroids and positive findings on orbital venography. It should be emphasized that Tolosa-Hunt's syndrome may not be a "pure syndrome." Perhaps it is only an occasional presentation of another rather poorly understood syndrome, that of "recurrent cranial neuropathies." The present patient had at least three episodes of painful ophthalmoplegia prior to this hospitalization. During the last hospitalization, he presented with painful ophthalmoplegia, showed a rapid response to steroids, had narrowing of the carotid artery on arteriogram and an abnormal orbital venogram. However, during his hospitalization he developed involvement of cranial nerves II, III, V, VI and VII, papilledema, pyramidal tract signs and severe psychiatric disturbances, all of which remitted. This, coupled with the abnormal pneumoencephalogram and electroencephalogram and organicity on psychological testing, suggests cerebral involvement in our case.
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PMID:Painful ophthalmoplegia: report of a case with cerebral involvement and psychiatric complications. 117 55

A 58-year-old woman with painful ophthalmoplegia of the left eye associated with thrombosis of the left superior ophthalmic vein and normal angiography is presented. Symptoms cleared on systemic prednisone therapy within 72 hours. The clinical picture associated with the venographic findings and response to steroids are characteristic of the Tolosa-Hunt syndrome.
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PMID:Tolosa-Hunt syndrome. 118 Apr 66


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