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Ophthalmology

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Neurophthalomlogy

Question
63 out of 91
 

Ipsilateral cavernous sinus thrombosis with painful Ophthalmoplegia with headache and Cavernous sinus enlargement is feature of? (AIIMS May 2008)



A Tolosa-Hunt syndrome

B Gradenigo syndrome

C Soto’s syndrome

D Marchiafava Bignami disease

Ans. A Tolosa-Hunt syndrome (Ref. Harrison's Principles of Internal Medicine 16th Edition pg. 173)

In Tolosa-Hunt syndrome, It is chronic granulomatous inflammation of the cavernous sinus causing severe eye pain and or damage of the nerves of the face.

Symptoms

1. Tolosa-Hunt syndrome begins with sudden severe pain behind or around one eye that comes on suddenly.

2. The pain can be constant and intense. As the sinus inflammation increases and spreads, nerves in the face can be affected, producing symptoms such as drooping eyelid (ptosis) of the affected eye or numbness and tingling in the forehead.

3. Difficulty controlling eye movements (ophthalmoplegia) and the pupil may cause sensitivity to light and double or blurred vision. If

Diagnosis

The International Headache Society criteria for Tolosa-Hunt syndrome are:

1. One-sided eye pain for an average of 8 weeks if left untreated
a. Associated irritation or damage to the third, fourth, or sixth cranial nerves
b. The pain is relieved within 48 hours of starting steroid
c. Other conditions have been ruled out by testing.

2. It is a diagnosis of exclusion

Treatment It is treated with steroid. Q

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