Criteria for Tolosa-Hunt Syndrome Examined

A discussion of a pediatric case and International Headache Society criteria

Tolosa-Hunt syndrome (THS) is characterized by steroid-responsive, painful ophthalmoplegia caused by granulomatous inflammation of the cavernous sinus. Few pediatric cases have been reported.

Zanus and colleagues describe an 8-year-old child with THS who presented with painful left third and fourth cranial nerve palsies. MRI of the brain revealed enhancing soft tissue within the left cavernous sinus. Serologic testing for underlying disorders was unremarkable. The pain responded to steroids within 3 days, and the ophthalmoplegia resolved by 2 weeks. After 6 months, the MRI findings had normalized.

The authors emphasized that the patient fulfilled the 2004 International Headache Society (IHS) criteria for THS (Cephalalgia 2004; 24 Suppl 1:9). …

Reviewing Author

Grant T. Liu, MD