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A Case of Tolosa-Hunt Syndrome Accompanied by Facial and Vestibular Nerve Damage Katsuichiro Okubo 1 , Takahiko Tokuda 1 , Akinori Nakamura 1 , Takao Hashimoto 1 , Chung-Sung Koh 1 , Nobuo Yanagisawa 1 1Department of Medicine (Neurology), Shinshu University School of Medicine Keyword: Tolsa-Hunt syndrome , facial nerve palsy , vestibular nerve damage , MRI , pachymeningitis pp.655-659
Published Date 1992/7/1
DOI https://doi.org/10.11477/mf.1406900362
  • Abstract
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A 37-year old man, who had repeatedly suffered from transient ophthalmoplegia in his left eye at the age of 29 and 36, developed left painful ophthalmo-plegia accompanied by ipsilateral facial nerve palsy in August, 1991. Neurological examination revealed involvement of the left oculomotor, trochlear, ophthalmic division of the trigeminal, abducens, facial and vestibular nerves. Gadolinium-enhanced MRI which was taken at the acute phase of the illness demonstrated markedly enhanced left cav-ernous sinus and adjacent thickened dura mater in the middle cranial fossa. At the remission phase after starting corticosteroid therapy, these enhan-ced lesions were no longer observed even in enhan-ced MRI studies. We diagnosed him as suffering from Tolosa - Hunt syndrome presently accom-panied by facial and vestibular nerve damage beca-use of his history of illness, confined lesion in the left cavernous sinus and steroid-induced remission.

We concluded that Tolosa-Hunt syndrome may be accompanied by damage of other cranial nerves in its course and that repeated gadolinium-enhan-ced MRIs are necessary for diagnosis and observa-tion of the patients.


Copyright © 1992, 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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