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TOLOSA-HUNT SYNDROME:REPORT OF A CASE AND COMMENT ON ITS NEW CLINICAL CRITERIA Yoshitomo Kashiki 1 , Hiromu Yamada 1 , Taketsugu Sakamoto 1 , Kazuki Sakata 1 12nd Department of Surgery, Gifu University School of Medicine pp.851-855
Published Date 1977/8/1
DOI https://doi.org/10.11477/mf.1406204111
  • Abstract
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A case of Tolosa-Hunt syndrome was presented and its clinical features were discussed in relation to the new clinical criteria proposed by Hunt in 1976.

The patient was a 23-year-old woman. Her chief complaints were right frontotemporal and retro-orbital remittent pain, transient right ptosis, double vision and visual disturbance.

On examination, papilledema, mydriasis, upper-nasal visual field defect and loss of visual acuity were noticed on the right side. The right third, fourth and sixth cranial nerves and the first branch of the right fifth cranial nerve were found to be impaired.

A right parasellar tumor was suspected at first, but it was excluded subsequently by carotid angio-graphy, orbital venography, brain scintigraphy, pneumoencephalography and CSF examination. Blood and urine examinations as well as otolar-yngological examination were nothing particular and syphilis was excluded. Under the diagnosis of Tolosa-Hunt syndrome, she was treated by intra-thecal administration of 8 mg of Dexamethason twice per week. In 3 weeks headache, right retro-orbital pain and sensory disturbance of the right forhead disappeared rapidly, although right mydri-asis and slight diplopia on upward gaze persisted.

During the follow-up period of 27 months, the patient's condition has remained the same and there has been no recurrence of previous symptoms.

The findings and clinical course of this case fit well to the new criteria of Tolosa-Hunt syndrome recently propose by Hunt. In this connection the new criteria of the disease was introduced and discussed on its various aspects.


Copyright © 1977, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 2185-405X 印刷版ISSN 0006-8969 医学書院

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