Abstract

Introduction: Tolosa Hunt syndrome is an idiopathic inflammation localised in the apex of the orbita, cavernous sinus and superior orbital fissura. Clinical presentation is orbital or periorbital pain, followed by cranial nevre paresis. Response to corticosteroids therapy is dramatic. Case: We present a 45 -year old male patient presenting with an acute- subacute right- sided supraorbital pain, followed by double vision. His neurological examination revealed a right sided 6th cranial nerve palsy. Asymetrical right cavernous sinus widening with contrast enhancement was detected in cranial magnetic imaging. We ruled out other conditions and began corticosteroid therapy with a rapid improvement of symptoms. Discussion: Tolosa Hunt syndrome should be considered in the etiology and differential diagnosis of painful ophtalmoplegia.

Key words: Tolosa Hunt syndrome, painful ophtalmoplegia