ICHD-II diagnostic criteria for Tolosa-Hunt syndrome in idiopathic inflammatory syndromes of the orbit and/or the cavernous sinus.
A bibliographical search was conducted for papers published between 1999 and 2007 to verify the validity of International Classification of Headache Disorders (ICHD)-II criteria for the Tolosa-Hunt syndrome (THS) in terms of (i) the role of magnetic resonance imaging (MRI); (ii) which steroid treatment should be considered as adequate; and (iii) the response to treatment. Of 536 articles, 48, reporting on 62 patients, met the inclusion criteria. MRI was positive in 92.1% of the cases and it normalized after clinical resolution. There was no evidence of which steroid schedule should be considered as adequate; high-dose steroids are likely to be more effective both to induce resolution and to avoid recurrences. Pain subsided within the time limit required by the ICHD-II criteria, but signs did not. We conclude that THS diagnostic criteria can be improved on the basis of currently available data. MRI should play a pivotal role both to diagnose and to follow-up THS.
Colnaghi
S
S
Department of Neurology, University of Pavia; Department of Neuro-Otology and Neuro-Ophthalmology, IRCCS Neurological Institute C. Mondino Foundation, Pavia, Italy. si.co@libero.it
Versino
M
M
Marchioni
E
E
Pichiecchio
A
A
Bastianello
S
S
Cosi
V
V
Nappi
G
G
D002426:Cavernous Sinus; D006801:Humans; D038801:International Classification of Diseases; D038622:Internationality; D054517:Orbital Cellulitis / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology; D017063:Outcome Assessment, Health Care / Q000379:methods; D017410:Practice Guidelines as Topic / Q000592:standards*; D011379:Prognosis; D012852:Sinusitis / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology; D020333:Tolosa-Hunt Syndrome / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology; D016896:Treatment Outcome