Tolosa-Hunt Syndrome in a Child.

Na,  Ji Hoon; Kim,  Hyo Jeong; Lee,  Joon Soo; Kim,  Heung Dong; Kang,  Hoon Chul

Case Report

Journal of the Korean Child Neurology Society 2013;21(4):268-271.
Published online December 30, 2013.

Tolosa-Hunt Syndrome in a Child.

Ji Hoon Na, Hyo Jeong Kim, Joon Soo Lee, Heung Dong Kim, Hoon Chul Kang

¹Division of Pediatric Neurology, Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Korea. hipo0207@yuhs.ac
²Department of Pediatrics, Konyang University College of Medicine, Korea.

Abstract

Tolosa-Hunt syndrome is a rare disease caused by non-specific inflammation of the cavernous sinus, superior orbital fissure and the apex of the orbit. It is characterized by ophthalmoplegia, unilateral headache or periorbital pain. Brain magnetic resonance imaging (MRI) usually shows an inflammation of cavernous sinus. It is known that steroid pulse therapy is effective. In this case, we diagnosed a 12-year-old female with Tolosa-Hunt syndrome suffered from left ophthalmoplegia and left sided headache. Her Brain MRI showed mild enlargement of left cavernous sinus. After methylprednisolone pulse therapy and following dexamethasone treatment, her symptoms were markedly improved. In children who suffer from periorbiral pain and ophthalmoplegia, proper brain MRI could be helpful in differential diagnosis including Tolosa-Hunt syndrome.

Key Words: Tolosa-Hunt syndrome, Cavernous sinus, Ophthalmoplegia, Eye pain, Headache