Dr.Kamakshi Bhaskar Vompolu

Dr.R. Suryanarayana Raju, Dr.Tarakeswara Rao Attada, Dr.Narasimha Rao Are Palli

Abstract

Tolosa-Hunt syndrome is a rare idiopathic condition caused by non specific granulomatous inflammation of cavernous sinus, superior orbital fissure and/orbital apex involving third, fourth sixth and superior division of fifth nerve .
A patient presented with diplopia, drooping of upper right eye upper lid since 3 days and right side headaches intermittently .Pt is a known hypertensive and diabetic .On ophthalmic examination right side ptosis and diplopia were present with painful ophthalmoplegia involving right third and sixth cranial nerves paralysis. Hence patient was put on for evaluation for Right multiple cranial nerve neuropathies. MRI was done suggesting right cavernous sinus inflammation with asymmetric thickening and enhancement. Multiple investigations were done which were negative and ruled out other systemic conditions. The clinical findings, investigations and prompt recovery with systemic steroids supports the diagnosis of TOLASA HUNT SYNDROME.