title: Tolosa-Hunt syndrome masquerading as Gradenigo syndrome in a teenager.
abstract: Tolosa-Hunt syndrome is an idiopathic chronic granulomatous inflammatory process commonly involving the cavernous sinus and the orbit. Symptoms include unilateral eye pain, ophthalmoplegia, headache, and facial pain in the distribution of the upper divisions of the trigeminal nerve and are highly responsive to steroid therapy. Gradenigo syndrome describes extension of a middle ear infection to the petrous apex, with trigeminal pain and ophthalmoplegia, typically responsive to antibiotics and often surgical drainage. We report a case of a 17 year-old girl with apparent Gradenigo syndrome, presenting with unilateral eye pain, abducens palsy, headache, hearing loss and serous otitis media, who was ultimately diagnosed with Tolosa-Hunt syndrome.
authors.affiliation: Departments of Otolaryngology, Radiology and Pediatrics, Washington University, 660 South Euclid Avenue, Campus Box 8115, St. Louis MO 63110, USA.
authors.forename: Eric
authors.initials: E
authors.lastname: Slattery
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: White
authors.forename: Megan
authors.initials: M
authors.lastname: Gauthier
authors.forename: Luke
authors.initials: L
authors.lastname: Linscott
authors.forename: Keiko
authors.initials: K
authors.lastname: Hirose
mesh_terms: D000293:Adolescent; D002426:Cavernous Sinus / Q000473:pathology*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D009886:Ophthalmoplegia / Q000175:diagnosis* / Q000209:etiology; D010033:Otitis Media / Q000175:diagnosis* / Q000209:etiology; D059270:Petrositis / Q000175:diagnosis*; D020333:Tolosa-Hunt Syndrome / Q000175:diagnosis*