Tolosa Hunt syndrome (THS)

Pathology

• This is low grade inflammation in the cavernous sinus and superior orbital fissure

Clinical features: painful unilateral ophthalmoplegia

Clinical features: cranial nerve involvement

Associated features

Course

Differential diagnosis

Magnetic resonance imaging (MRI)

Cerebrospinal fluid (CSF) analysis

Treatment

References

1. Hunt WE, Meagher JN, LeFever HE, Zeman W. Painful ophthalmoplegia: its relation to indolent inflammation of the cavernous sinus. Neurology 1961; 11:56-62.
2. Kline LB, Hoyt WF. The Tolosa-Hunt syndrome. JNNP 2001; 71:577-582.
3. Madhavan AA, DeLone DR, Verdoorn JT. Bilateral facial nerve involvement in a patient with Tolosa-Hunt syndrome. Neuroradiol J 2020; 33:424-427. 
4. Arora H, Pasricha R, Sharma V. Tolosa-Hunt syndrome with anisocoria as the sole presenting ophthalmic sign. Prim Care Companion CNS Disord 2021; 23:20l02798.
5. Yang Q, Lai C, Meng C, Chang Q, Wang J. Clinical and cerebrospinal fluid characteristics in 55 cases of tolosa-hunt syndrome: a retrospective analytical study. Eur Neurol 2022; 85:265-272. 
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Related checklists

• Orbital apex syndrome
• Cavernous sinus syndrome (CSS)