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Tolosa-Hunt syndrome masquerading as a carotid artery dissection

PURPOSE: To demonstrate the difficulties of diagnosing a patient with Tolosa-Hunt syndrome (THS) due to its complicated presentation and extensive diagnostic testing, and how to manage the treatment of a patient in an emergent setting. PATIENTS AND METHODS: A female patient with THS affecting the le...

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Autores principales: Taylor, Elise J, Anders, Ursula M, Martel, Joseph R, Martel, James B
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove Medical Press 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3984061/
https://www.ncbi.nlm.nih.gov/pubmed/24741291
http://dx.doi.org/10.2147/OPTH.S62787
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author Taylor, Elise J
Anders, Ursula M
Martel, Joseph R
Martel, James B
author_facet Taylor, Elise J
Anders, Ursula M
Martel, Joseph R
Martel, James B
author_sort Taylor, Elise J
collection PubMed
description PURPOSE: To demonstrate the difficulties of diagnosing a patient with Tolosa-Hunt syndrome (THS) due to its complicated presentation and extensive diagnostic testing, and how to manage the treatment of a patient in an emergent setting. PATIENTS AND METHODS: A female patient with THS affecting the left eye was examined using two magnetic resonance imaging (MRI) scans. The patient was treated with high-dose methylprednisolone (Solu-Medrol(®)) and prednisone. A follow-up MRI and magnetic resonance angiogram (MRA) was also performed 4 months later. RESULTS: The second MRI scan disclosed a 5×9×10 mm lesion in the left superior orbital fissure/cavernous sinus. After administration of methylprednisolone and prednisone, the patient’s pain completely resolved, and the left eye regained full duction and eyelid mobility. The MRI and MRA obtained after the treatment showed no abnormalities. CONCLUSION: The rarity of THS makes it difficult to diagnose, especially when there is a question of accuracy and reproducibility of the testing performed. An ophthalmologic consultation in such cases is crucial.
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spelling pubmed-39840612014-04-16 Tolosa-Hunt syndrome masquerading as a carotid artery dissection Taylor, Elise J Anders, Ursula M Martel, Joseph R Martel, James B Clin Ophthalmol Case Report PURPOSE: To demonstrate the difficulties of diagnosing a patient with Tolosa-Hunt syndrome (THS) due to its complicated presentation and extensive diagnostic testing, and how to manage the treatment of a patient in an emergent setting. PATIENTS AND METHODS: A female patient with THS affecting the left eye was examined using two magnetic resonance imaging (MRI) scans. The patient was treated with high-dose methylprednisolone (Solu-Medrol(®)) and prednisone. A follow-up MRI and magnetic resonance angiogram (MRA) was also performed 4 months later. RESULTS: The second MRI scan disclosed a 5×9×10 mm lesion in the left superior orbital fissure/cavernous sinus. After administration of methylprednisolone and prednisone, the patient’s pain completely resolved, and the left eye regained full duction and eyelid mobility. The MRI and MRA obtained after the treatment showed no abnormalities. CONCLUSION: The rarity of THS makes it difficult to diagnose, especially when there is a question of accuracy and reproducibility of the testing performed. An ophthalmologic consultation in such cases is crucial. Dove Medical Press 2014-04-07 /pmc/articles/PMC3984061/ /pubmed/24741291 http://dx.doi.org/10.2147/OPTH.S62787 Text en © 2014 Taylor et al. This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution – Non Commercial (unported, v3.0) License The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.
spellingShingle Case Report
Taylor, Elise J
Anders, Ursula M
Martel, Joseph R
Martel, James B
Tolosa-Hunt syndrome masquerading as a carotid artery dissection
title Tolosa-Hunt syndrome masquerading as a carotid artery dissection
title_full Tolosa-Hunt syndrome masquerading as a carotid artery dissection
title_fullStr Tolosa-Hunt syndrome masquerading as a carotid artery dissection
title_full_unstemmed Tolosa-Hunt syndrome masquerading as a carotid artery dissection
title_short Tolosa-Hunt syndrome masquerading as a carotid artery dissection
title_sort tolosa-hunt syndrome masquerading as a carotid artery dissection
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3984061/
https://www.ncbi.nlm.nih.gov/pubmed/24741291
http://dx.doi.org/10.2147/OPTH.S62787
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