title: Tolosa-Hunt syndrome misdiagnosed as sinusitis complication.
abstract: OBJECTIVE
  Tolosa-Hunt syndrome is a rare condition of painful ophthalmoplegia combined with ipsilateral ocular motor nerve palsies, caused by non-specific granulomatous inflammation in the cavernous sinus, superior orbital fissure or orbit. A case of Tolosa-Hunt syndrome misdiagnosed as sinusitis orbital complication is reported.
  
  
  METHODS
  A patient suffering from left periorbital pain, upper eyelid oedema and ptosis, and horizontal diplopia, diagnosed as sinusitis orbital complication, was referred to our department. Clinical evaluation revealed only a left VIth nerve paresis. Haematological studies, cerebrospinal fluid tests and computed tomography scanning were negative. A magnetic resonance imaging (MRI) scan showed enhancement of the left cavernous sinus. Corticosteroid therapy was commenced, and within three days all symptoms disappeared. A diagnosis of Tolosa-Hunt syndrome was made. Follow-up MRI studies were normal.
  
  
  CONCLUSIONS
  Tolosa-Hunt syndrome, although rare, is a nosological entity that otolaryngologists must bear in mind. Magnetic resonance imaging studies are essential in the diagnosis and follow up of these patients, in order to avoid a mistaken Tolosa-Hunt syndrome diagnosis.
authors.affiliation: Department of Otolaryngology, General Hospital of Larissa, Larissa, Greece.
authors.forename: V A
authors.initials: VA
authors.lastname: Lachanas
authors.forename: G T
authors.initials: GT
authors.lastname: Karatzias
authors.forename: I
authors.initials: I
authors.lastname: Tsitiridis
authors.forename: I
authors.initials: I
authors.lastname: Panaras
authors.forename: V G
authors.initials: VG
authors.lastname: Sandris
mesh_terms: D000328:Adult; D003937:Diagnosis, Differential; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009886:Ophthalmoplegia / Q000209:etiology; D012852:Sinusitis / Q000175:diagnosis*; D020333:Tolosa-Hunt Syndrome / Q000175:diagnosis*