alexa Tolosa Hunt Syndrome: Increased Severity on Second Attack
ISSN: 2329-9126

Journal of General Practice
Open Access

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Case Report

Tolosa Hunt Syndrome: Increased Severity on Second Attack

Ali A Alzu’bi*
Internal Medicine Department, King Hussein Medical City, Royal Medical Services, Jordan
Corresponding Author : Ali A. Alzu’bi
Internal Medicine Department, King Hussein Medical City
Royal Medical Services, Jordan
Tel: 00962777786271
E-mail: [email protected]
Received: January 05, 2016; Accepted: January 19, 2016; Published: January 25, 2016
Citation: Alzu’bi AA (2016) Tolosa Hunt Syndrome: Increased Severity on Second Attack. J Gen Pract 4:226. doi: 10.4172/2329-9126.1000226
Copyright: © 2016 Alzu’bi AA. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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Abstract

Tolosa Hunt syndrome (THS) is a rare cause of painful ophthalmoplegia with an estimated annual incidence of 1 case per million per year. It is caused by a nonspecific inflammatory process, of unknown etiology, involving the cavernous sinus, the superior orbital fissure and/or the orbital apex. It is classically described as an episodic orbital pain associated with paralysis of one or more of the 3rd, 4th and 6th cranial nerves, resolving spontaneously or with the commencement of steroids. I report a female patient who had 2 attacks of THS separated by a period of 10 months. She presented with retro-orbital headache, exophthalmos, and ophthalmoplegia of left eye, on both attacks, and was treated with high dose prednisolone. On first attack she improved within 6 weeks of treatment. On second attack, the patient had a higher Erythrocyte sedimentation rate (ESR) and developed 2 relapses on corticosteroids tapering, requiring a prolonged course of treatment, for 27 weeks, which suggests that the disease activity may get more severe on further attacks of the disease.

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