Definition:
Tolosa-Hunt syndrome (THS) is a rare disorder marked by severe and unilateral headaches with extraocular palsies, usually involving the third, fourth, fifth, and sixth cranial nerves, and pain around the sides and back of the eye, along with weakness and paralysis (ophthalmoplegia) of certain eye muscles.
Diagnosis:
THS is usually diagnosed via exclusion, and as such a vast amount of laboratory tests are needed to rule out other causes of the patients symptoms. These tests include a complete blood count (CBC), thyroid function tests and serum protein electrophoresis.
Treatment:
Treatment of THS is typically completed using corticosteroids (often Prednisone) and immunosupressive agents (such as Methotrexate or Azathioprine). Corticosteroids act as analgesia and lessen pain (usually within 24-72 hours), as well as reducing the inflammatory mass, whereas immunosupressive agents help reduce the autoimmune response.
Symptoms and Signs:
Symptoms are usually restricted to one hemisphere of the brain, and in most cases the individual effected will experience intense, sharp pain and paralysis of muscles around the eye.
Causes:
The exact cause of THS is not known, but the disorder is thought to be, and often assumed to be, linked with inflammation of the areas behind the eyes (cavernous sinus and superior orbital fissure).
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