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Revista chilena de neuro-psiquiatría

versión On-line ISSN 0717-9227

Resumen

SILVA, Carlos  y  ARAYA, Paula. Tolosa-Hunt Syndrome: A Review of Two Cases. Rev. chil. neuro-psiquiatr. [online]. 2002, vol.40, n.3, pp.258-262. ISSN 0717-9227.  http://dx.doi.org/10.4067/S0717-92272002000300008.

In 1954 Tolosa, and later, Hunt, described a clinical disorder characterized by intense unilateral orbital pain, and oculomotor and trigeminal first division dysfunction. The disorder responds dramatically to steroids, and the few histopathological analyses reveal an unspecific granuloma of the cavernous sinus. We describe two cases of Tolosa-Hunt Syndrome. The first is a 24-year-old woman with left orbital pain, complete oculomotor dysfunction, and trigeminal first division affection. Almost all the evaluation was normal including angiography, but MRI showed a T1 isointense thickening in the cavernous sinus. The second case was a 50-year-old woman with clinical characteristics similar to those of the first subject. The laboratory assessment was completely normal, including the MRI. Both patients had an excellent response to steroids, remaining asymptomatic after 2 years of follow up. We emphasize the importance of neuroimaging in the differential diagnosis of this syndrome, specially the MRI. Once other cavernous sinus pathologies have been ruled out, the response to steroids and the clinical follow-up of the patients allows to diagnose a Tolosa-Hunt syndrome without recurring to high-risk procedures, specifically a cavernous sinus biopsy, which is the only means to confirm histopathologically this disease

Palabras clave : Tolosa Hunt Syndrome; cavernous sinus syndrome; cavernous sinus granulomatosis; ophthalmoplegia pain; orbital pain.

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