Tolosa-Hunt syndrome: A 48year male with history of facial palsy

Abstract

Tolosa-Hunt syndrome is a rare disease characterized by intense periorbital headaches, along with ophthalmoplegia. Symptoms are usually unilateral. A 48-year-old male presented with right eye dropping (R ptosis) and double vision from 2 weeks, which was progressive along with pain involving LMN VII palsy. The pain was severe in intensity, continuous and sharp. It had been diagnosed as Tolosa-Hunt syndrome based on MRI, steroid response, CSF analysis, other rule outing investigations. Corticosteroids were prescribed as the treatment. The patient found to be better with the therapy and tapering was done. Later, due to fontal headache azathioprine added as immunosuppressants. The clinical symptoms are similar to other diseases like migraine headache, orbital cellulitis. This case report focus on the diagnosis and treatment of Tolosa hunt syndrome.