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

The Tolosa-Hunt syndrome is characterized by recurrent periods of painful ophthalmoplegia, dramatically ameliorated by steroid treatment. In half of the cases orbital phlebography shows characteristic changes. Ninety-six patients with orbital pain characteristic of the Tolosa-Hunt syndrome were submitted to orbital phlebography regardless of the existence of other symptoms. A pathologic phlebogram with changes typical of the Tolosa-Hunt syndrome was found in 50 patients. In 17 of these 50 patients the symptoms consisted of orbital pain only and no ophthalmoplegia. Twenty patients had pain and ipsilateral decrease of vision but no ophthalmoplegia, and 13 had painful ophthalmoplegia. Of 41 patients treated with steroid medication 39 responded dramatically with regard to the pain. Earlier findings indicate that the phlebographic changes are due to venous vasculitis, which thus may cause irreversible visual impairment but also chronic headache without ophthalmoplegia. It is concluded that the Tolosa-Hunt syndrome may be only one manifestation of a not uncommon disease.
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PMID:A new etiology for visual impairment and chronic headache. The Tolosa-Hunt syndrome may be only one manifestation of venous vasculitis. 369 95

Among the painful ophthalmoplegias, ophthalmoplegic migraine and Tolosa-Hunt syndrome share many features. Our 6-year-old patient had three episodes of ophthalmoplegia. Two episodes were painful and promptly resolved with oral prednisone. She had no evidence of parasellar or systemic disease. A review of published cases of ophthalmoplegic migraine demonstrated that the clinical history, the cornerstone of diagnosis in migraine, does not differentiate ophthalmoplegic migraine from Tolosa-Hunt syndrome. Other features helpful in the diagnosis of Tolosa-Hunt syndrome were not usually investigated in reports of ophthalmoplegic migraine. Until better criteria are available for differentiating the two entities, we suggest that children who fulfill the clinical criteria for Tolosa-Hunt syndrome receive a trial of steroid therapy.
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PMID:Steroid-responsive ophthalmoplegia in a child. Diagnostic considerations. 400 4

Pain characteristics of the Tolosa-Hunt syndrome were abstracted from the observations of five patients with repeated incidents of painful ophthalmoplegia. The pain was experienced either as pressure behind the ophthalmoplegic eye or as boring pain in one orbital region, fluctuating in intensity, sometimes worsening to knife stab-like pain in the eye. The unilateral pain did not shift side during a solitary incident of painful ophthalmoplegia and was never completely absent. The pain was increased when the eyes were strained, when cold wind blew against the face, and when a change in the weather took place. It was accompanied by a feeling of swelling in the affected region, but not by nausea nor vomiting. Conventional headache drugs provided little relief. All cases experienced tenderness when pressure was applied to the ipsilateral supraorbital foramen. The pain was suggested to be related to an increased load on the impaired venous blood flow in the region of the superior orbital fissure.
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PMID:Pain characteristics of painful ophthalmoplegia (the Tolosa-Hunt syndrome). 401 17

The authors report 11 cases of Tolosa-Hunt syndrome, a painful ophthalmoplegia due to an aspecific, benign, steroid-responsive inflammation of the cavernous sinus. Other causes of painful ophthalmoplegia, diagnostic findings and etiological hypothesis are discussed.
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PMID:[Tolosa-Hunt syndrome. Observations in 11 cases]. 403 55

The Tolosa-Hunt syndrome (THS) is characterized by remittent and sometimes recurring episodes of painful ophthalmoplegia. The etiopathogenesis is still unclear and is an object of controversy. A non-specific granulomatous process of the wall of the cavernous sinus is claimed by many authors as the possible cause, on the basis of a few pathological studies. Other authors suggest the possible role of autoimmune or specific inflammatory processes localized in the retroorbital perineural tissues. The clinical, laboratory and radiological findings of the eight cases reported in the agreement with those previously described in the literature. However, the visual evoked potentials (VEP) were delayed in three of the four cases in which they had been studied. This finding, together with the observation that some analogies exist between THS and other well known neuritic processes of the cranial nerves, may suggest that at least in some cases THS may be related to an ocular polyneuritis.
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PMID:The tolosa-Hunt syndrome: further clinical and pathogenetic considerations based on the study of eight cases. 616 18

Painful ophthalmoplegia occurred in a twelve-year-old boy, with repeated attacks over five years. This fits the description of Tolosa-Hunt syndrome which has only infrequently been described in children. Tolosa-Hunt syndrome combines severe lasting orbital pain and paralysis of one or more oculomotor nerves (extrinsic or intrinsic III, IV, VI). Pain is dramatically alleviated by high doses of corticosteroids, while the ophthalmoplegia improves more slowly. For some authors, this effect of corticosteroids is diagnostic. Repeated attacks occur over several years and resolve spontaneously with or without sequellae. Diagnosis can only be ascertained after careful ruling out of a general or locoregional etiology through clinical and paraclinical investigations. Differential diagnosis with ophthalmoplegic migraine may be difficult.
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PMID:[Painful Tolosa-Hunt ophthalmoplegia. Apropos of a case in a child]. 630 8

The Tolosa-Hunt syndrome is characterized by recurrent unilateral painful ophthalmoplegia which responds to systemic steroid therapy dramatically. The etiology appears to be a non-specific inflammation in the cavernous sinus and the superior orbital fissure. Two interesting cases similar to this syndrome are described. One is a 54-year-old man with moderate left exophthalmos who had no complaint of retro-orbital pain. CT scan demonstrated the left orbital tumor, and the orbital decompression surgery was performed. The white-yellowish tumor was found extending the orbit through the superior orbital fissure into the cavernous sinus. Histological examination revealed non-specific inflammatory granuloma. Despite the unusual clinical symptoms, the etiology of this case appeared to be identical with the Tolosa-Hunt syndrome. The other case is a 16-year-old girl who had a 2 years' history of recurrent left retro-orbital pain and the complete IIIrd nerve palsy. CT scan demonstrated a small enhancing lesion in the cavernous sinus. Corticosteroid treatment improved her IIIrd nerve palsy within 2 days, however the CT scan after the treatment revealed no change of the lesion size. Left frontotemporal craniotomy was performed and the whitish tumor in the cavernous sinus was partially removed. Histological examination revealed that the tumor was typical meningioma with whorl-formation. The anatomical structure of the cavernous sinus is so complicated that the diseases arising from this area show quite different appearances. For the differential diagnosis of these lesions, the carotid angiography and the cavernous sinus venography were said to be useful.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[2 cases simulating Tolosa-Hunt syndrome]. 662 87

The Tolosa-Hunt syndrome, or painful ophthalmoplegia, is a rare condition caused by a granulomatous nonspecific process at the level of anterior cavernous sinus, superior orbital fissure and orbital apex. The syndrome is characterized by pain behind, above or around the eye, involvement of the cranial nerves which pass through the cavernous sinus, spontaneous remissions and exacerbations, and a favourable response to steroid therapy. Recognition of this condition is important because administration of steroids may prevent residual damage.
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PMID:The Tolosa-Hunt syndrome. 684 50

A case of Tolosa-Hunt syndrome with unusual course is described. Pain and ophthalmoplegia were both relatively late manifestations preceded for several weeks by progressive involvement of the optic nerve. The importance of also bearing this condition in mind in atypical cases is stressed, since early diagnosis and corticosteroid treatment distinctly reduce the risk of severe residual symptoms.
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PMID:Unusual course of painful ophthalmoplegia. Report of a case. 721 Dec 72

A 48-year-old woman was referred to the First Dept. of Int. Med., Nagasaki Univ. Sch. Med., in August, 1979, with a six-month history of recurrent episodes of right-sided painful ophthalmoplegia and diplopia. An epidode affected the right eye, lasted one to two weeks, and relapsed every month. On examination she had a complete ptosis on the right side and pain on the right eye. All extraocular muscle supplied by the 3rd nerve were paralysed. The pupils were equal in size both sides, reacting to light completely. Visual acuity was normal except myopia. All the other cranial nerves and the remainder of central nervous system was normal. Results of thyroid function tests and of lumbar puncture were normal. The glucose tolerance test showed a mild diabetic pattern. Blood and CSF cultures for bacteria, fungi, and acid-fast bacillus were negative. The skull, brain CT scan, and carotid angiogram were within normal limits. A tentative diagnosis of Tolosa-Hunt syndrome was made after an unproductive search for a cause for this woman's painful ophthalmoplegia and unsuccessful treatment of ophthalmoplegia with antibiotics or diet therapy for mild hyperglycemia. The patient was given prednisolone 30 mg daily orally when she had the 9th attack of painful ophthalmoplegia Pain, ptosis, and diplopia disappeared in 5 days and she did not show any recurrence of symptoms over the next 7 months.
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PMID:[The Tolosa-Hunt syndrome: report of a case with recurrent (9 times) painful ophthalmoplegia (author's transl)]. 732 86


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