Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0029089 (ophthalmoplegia)
 3,338 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Charts from patients admitted from April 1976 to March 1986 to the departments of neurology, neurosurgery, ophthalmology and pediatrics serving a population of 615,000 inhabitants in Copenhagen County were surveyed. We then examined patients with coexisting headache and ophthalmoplegia at follow-up. Many diseases may mimic a single attack of ophthalmoplegic migraine. We found 4 cases of ophthalmoplegic migraine, i.e. an annual incidence of 0.7 per million inhabitants. We added another 4 cases from the same area, but diagnosed before or after the study period. Only in 2 of the 8 cases did the ophthalmoplegic episodes fulfil criteria for pain and associated symptoms required for migraine without aura (common migraine). In contrast, the clinical characteristics of the attacks are typical of the Tolosa-Hunt syndrome. When this inflammatory disease strikes a migraineur it is likely to elicit headache with migrainous features. We postulate that such cases have been diagnosed as ophthalmoplegic migraine, whereas the proper diagnosis of Tolosa-Hunt syndrome has been made in non-migraineurs.
 ...
PMID:Ophthalmoplegic migraine: diagnostic criteria, incidence of hospitalization and possible etiology. 233 Aug 16

A 58-year-old male presented with painful right ophthalmoplegia and was diagnosed as having Tolosa-Hunt syndrome. High-dose oral administration of a corticosteroid provided significant pain relief, but total ophthalmoplegia persisted. Computed tomography (CT) showed a tumor-like mass in the bilateral cavernous sinus. Angiography revealed occlusion of the right internal carotid artery. According to the literature, about 70% of cases of Tolosa-Hunt syndrome are caused by parasellar neoplasms. A transcranial biopsy of the patient's lesion revealed a nonspecific granulomatous process in the wall of the right cavernous sinus. He was again placed on high-dose corticosteroid therapy and within 1 week the right visual acuity improved slightly. The corticosteroid dose was gradually tapered over 3 months. After 2 months of therapy, the external ocular movement had almost fully recovered, although the light reflex was absent and the CT findings did not change.
 ...
PMID:[Tolosa-Hunt syndrome. Report of a surgical case]. 248 47

The Tolosa-Hunt syndrome consists of painful ophthalmoplegia caused by cavernous sinus inflammation, which is responsive to steroid therapy. The MR features of 11 patients with the clinical diagnosis of Tolosa-Hunt syndrome were studied. Two patients had normal MR studies of the orbit and cavernous sinuses. In nine patients, abnormal signal and/or mass lesions were seen in the cavernous sinuses; in eight cases, the abnormality was hypointense relative to fat and isointense with muscle on short TR/TE images and isointense with fat on long TR/TE scans. Extension into the orbital apex was seen in eight cases. In six of nine cases the affected cavernous sinus was enlarged; in five of nine it had a convex outer margin. One patient had a thrombosed cavernous sinus and superior ophthalmic vein in addition to a cavernous sinus soft-tissue mass. The signal intensity of Tolosa-Hunt syndrome in this limited series was similar to that of orbital pseudotumor and is confined to a limited differential diagnosis, which includes meningioma, lymphoma, and sarcoidosis.
 ...
PMID:MR imaging of Tolosa-Hunt syndrome. 251 79

A case of painful ophthalmoplegia due to idiopathic granulomatous involvement of the superior orbital fissure (Tolosa-Hunt syndrome) is described. The clinical features of recurrent pain, ocular motor nerve palsies and proptosis correlated well with the eventual demonstration of an enhancing mass in the region of the cavernous sinus. Removal of the lesion led to a resolution of the clinical picture and demonstration of a non-caseating granuloma with no other detectable cause. The original observation of Tolosa was thus re-affirmed.
 ...
PMID:Clinicopathological correlation in a case of painful ophthalmoplegia: Tolosa-Hunt syndrome. 259 72

A 50-year-old woman developed third, fourth, and fifth cranial nerve palsies in the right associated with frontal pain in the ipsilateral side. Oral administration of prednisolone (30 mg/day) was initiated. The painful ophthalmoplegia improved dramatically following this treatment. Three months later, the patient developed the third, fourth, and fifth cranial palsies in the left which was contralateral to the previous episode. The patient had pain in the left frontal region. The corticosteroid therapy was again effective. Cavernous sinus and orbital venographies demonstrated a constriction of the right superior ophthalmic vein in the first and third parts, with a partial filling of the cavernous sinus. The left superior vein and cavernous sinus were normal. A left carotid arteriogram showed a slight deformity of the carotid siphon in the left. The glucose tolerance test demonstrated a mild diabetic pattern. Diabetic ophthalmoplegia can also be suspected in this case, however, the finding of a partial filling of the right cavernous sinus was indicative of Tolosa-Hunt syndrome. Therefore this case was diagnosed as Tolosa-Hunt syndrome. Alternating relapsing Tolosa-Hunt syndrome involving the third, fourth and fifth cranial nerve as seen in this case is very rare. There are many diseases which may demonstrate similar symptoms; i.e. parasellar tumor, aneurysm, diabetic ophthalmoplegia, multiple cranial neuropathy, etc. The pathologic process involved in Tolosa-Hunt syndrome is poorly understood and it appears that the clinical entity of this syndrome should be questioned. We believe that it is necessary to clarify the precise pathologic process involved in this syndrome and its relation with other similar syndromes exhibiting similar symptoms.
 ...
PMID:[A case of alternating Tolosa-Hunt syndrome]. 275 59

The authors give a review on the Tolosa-Hunt Syndrome. They discuss its differential diagnosis, appropriate diagnostic and therapeutic measures for the evaluation of this painful ophthalmoplegia which may be combined with neurological deficit referrable to the anterior cavernous sinus.
 ...
PMID:The Tolosa-Hunt syndrome: a problem in differential diagnosis. 305 32

We experienced 9 patients with "painful ophthalmoplegia", which included 7 cases of the Tolosa-Hunt syndrome (2 males and 5 females, with ages ranging from 36 to 65 years) and 2 cases of the orbital pseudotumor syndrome (2 females aged 42 and 68). The diagnosis of these syndromes was based upon Hunt's criteria and the presence of the intraorbital mass on the brain CT scan. Main manifestations of both syndromes were periorbital pain and ipsilateral oculomotor nerve palsies. Out of 9 cases, 1 patient with Tolosa-Hunt syndrome and 1 patient with the orbital pseudotumor syndrome had bilateral retro-orbital pain and ophthalmoplegia. Pain preceded the ophthalmoplegia except in one patient with Tolosa-Hunt syndrome. Total paralysis of the extraocular muscles supplied by the oculomotor nerve was noted in all the nine patients, and mydriasis was observed on the affected side in 4 of 7 patients with Tolosa-Hunt syndrome and 2 patients with the orbital pseudotumor syndrome. Neurological involvement was not only the oculomotor nerve but also the other cranial nerves; the optic nerve (in 4 cases with Tolosa-Hunt syndrome and 2 cases with the orbital pseudotumor syndrome), the abducens nerve (in 3 cases with Tolosa-Hunt syndrome and 1 case with the orbital pseudotumor syndrome), and the first division of the trigeminal nerve (in 2 cases with Tolosa-Hunt syndrome). Six patients with Tolosa-Hunt syndrome and 2 patients with the orbital pseudotumor syndrome had palpebral edema. Visual disturbance and palpebral edema were severer in the patients with the orbital pseudotumor syndrome. After corticosteroid hormone was administered, there was diminution of the pain within 2 weeks.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:[Painful ophthalmoplegia: the Tolosa-Hunt syndrome and orbital pseudotumor syndrome]. 317 90

The Tolosa-Hunt syndrome (THS), a steroid-responsive painful ophthalmoplegia secondary to idiopathic granulomatous inflammation, historically has been categorized as a diagnosis of exclusion because of its nonspecific radiologic presentation. Five patients who satisfied the anatomic and clinical criteria of this syndrome underwent high-resolution CT of the orbital apex/cavernous sinus region. Two patients were diagnosed as having orbital apex pseudotumor, two as having cavernous sinus inflammation, and one as having a cavernous sinus epidermoid by the characteristic CT and clinical findings. Follow-up studies while the patients were asymptomatic demonstrated complete resolution of the CT abnormalities in four patients and clinical improvement in all five patients. Our data suggest that orbital apex pseudotumor and granulomatous inflammation of the cavernous sinus have similar clinical features and should be considered as part of the spectrum of THS. With the advent of high-resolution CT, THS may now be a diagnosis of inclusion. Symptomatic improvement after steroid therapy is an essential but not absolute proof of the syndrome, since lesions such as lymphomas may also respond to steroids. Resolution of the soft-tissue inflammation of CT is an additional criterion for diagnosis.
 ...
PMID:Tolosa-Hunt syndrome revisited: not necessarily a diagnosis of exclusion. 325 34

CT and MRI have become imaging techniques of great value in the diagnosis of vascular orbital lesions. Intraorbital vascular lesions, vascular tumors, intracranial aneurysms, carotid cavernous fistulas, and Tolosa-Hunt syndrome are discussed in detail. They illustrate how the accuracy of CT and MRI in evaluating orbital and intracranial masses has focused the role of angiography in exophthalmos and ophthalmoplegia on detection and assessment of those vascular lesions that may require surgical intervention.
 ...
PMID:The role of the neuroradiologist in vascular disorders involving the orbit. 329 79

Two patients are described who had suffered for 12 years from episodes of painful ophthalmoplegia consistent with a Tolosa-Hunt syndrome (THS) alternating with palsies of cranial nerves other than the oculomotor (fifth motor and seventh on both sides). These two cases, as well as other similar ones previously reported in the literature, suggest that THS may sometimes be a variant of so-called recurrent cranial neuropathy, which is a benign and poorly understood clinical entity on an inflammatory or ischaemic basis.
 ...
PMID:Tolosa-Hunt syndrome versus recurrent cranial neuropathy. Report of two cases with a prolonged follow-up. 355 35


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>