Recurrent, alternating Tolosa-Hunt syndrome.
A 24-year-old woman presented with right face pain and blurry vision. Examination revealed right pupil-sparing third nerve palsy and decreased sensation in the second and third divisions of the right trigeminal nerve. MRI demonstrated right cavernous sinus enhancement. Infectious, rheumatologic, and neoplastic evaluation was negative, and the patient was diagnosed with Tolosa-Hunt syndrome. Corticosteroid therapy resulted in resolution of all symptoms. Ten months later, the patient developed left face pain and double vision with a left third nerve palsy on examination. MRI revealed an enhancing left cavernous sinus. High-dose corticosteroid therapy again led to resolution of symptoms. This case demonstrates that Tolosa-Hunt syndrome can rarely recur on the contralateral side. MRI of this presentation has not been previously reported in the literature.
Navi
Babak B
BB
Department of Neurology and Neuroscience, Weill Medical College of Cornell University, New York, NY 10021, USA.
Safdieh
Joseph E
JE
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D001921:Brain / Q000473:pathology; D002426:Cavernous Sinus / Q000473:pathology*; D005260:Female; D007839:Functional Laterality; D006801:Humans; D008279:Magnetic Resonance Imaging; D020333:Tolosa-Hunt Syndrome / Q000188:drug therapy* / Q000473:pathology*; D016896:Treatment Outcome; D055815:Young Adult
D000305:Adrenal Cortex Hormones