Painful ophthalmoplegia with reversible carotid stenosis in a child.
Painful ophthalmoplegia in childhood has different causes. One is Tolosa-Hunt syndrome, in which a first episode may be difficult to diagnose because of its clinical similarity to ophthalmoplegic migraine. A 10-year-old male with painful ophthalmoplegia and a cavernous sinus inflammation associated with an intracavernous carotid stenosis demonstrated by magnetic resonance imaging and angiography is reported. These findings resolved in follow-up imaging. This report suggests that in the presence of painful ophthalmoplegia, magnetic resonance imaging detection of cavernous sinus inflammation can facilitate the diagnosis of Tolosa-Hunt syndrome when other causes are excluded.
del Toro
M
M
Pediatric Neurology Unit, Hospital Materno-Infantil Vall d'Hebron, Barcelona, Spain.
Macaya
A
A
Vazquez
E
E
Roig
M
M
D001763:Blepharoptosis / Q000209:etiology; D016893:Carotid Stenosis / Q000150:complications* / Q000473:pathology; D002426:Cavernous Sinus / Q000473:pathology*; D002648:Child; D003937:Diagnosis, Differential; D006801:Humans; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D008297:Male; D009886:Ophthalmoplegia / Q000150:complications / Q000175:diagnosis*; D010146:Pain / Q000209:etiology*; D012075:Remission, Spontaneous; D020333:Tolosa-Hunt Syndrome / Q000150:complications / Q000175:diagnosis* / Q000209:etiology