Tolosa-Hunt syndrome in a patient with systemic lupus erythematosus.
We report a case of Tolosa-Hunt syndrome (THS) in a patient with systemic lupus erythematosus studied with MRI. Magnetic resonance showed enlargement of the cavernous sinus and compression of the carotid syphon by enhancing tissue. In particular, fat-suppressed T1-weighted images before and after contrast agent injection and MR angiography showed extension of the abnormal tissue to the apex of the orbit and narrowing of the internal carotid artery. A presumptive diagnosis of THS was made and steroid treatment was started with rapid relief of symptoms. Follow-up MR study after steroid therapy demonstrated sub-total resolution of the neuroradiological findings. Neuroradiological findings in THS are quite typical but they may be subtle; furthermore, the presence of a systemic disease may suggest secondary involvement of the cavernous sinus. Utilization of the appropriate MR techniques and follow-up exams may contribute to the diagnosis of THS even in the presence of other systemic diseases.
Calistri
Valentina
V
Department of Neurological Sciences, University of Rome "La Sapienza", Viale dell' Università 30, 00185 Rome, Italy.
Mostardini
Claudio
C
Pantano
Patrizia
P
Pierallini
Alberto
A
Colonnese
Claudio
C
Caramia
Francesca
F
D000328:Adult; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications*; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D020333:Tolosa-Hunt Syndrome / Q000150:complications / Q000175:diagnosis*