Who is Tolosa Hunt?

Tolosa-Hunt syndrome is a rare disorder characterized by severe periorbital headaches, along with decreased and painful eye movements (ophthalmoplegia). Symptoms usually affect only one eye (unilateral). In most cases, affected individuals experience intense sharp pain and decreased eye movements.

Who discovered Tolosa-Hunt syndrome?

Tolosa Hunt syndrome was first described in the year 1954 by Dr. Eduardo Tolosa, a Spanish neurosurgeon. [1] Similar cases were reported by Hunt et al.

What causes Tolosa-Hunt syndrome?

The Tolosa-Hunt syndrome is caused by an inflammatory process of unknown etiology. On histopathology, there is a nonspecific inflammation of the septa and wall of the cavernous sinus, with a lymphocyte and plasma cell infiltration, giant cell granulomas, and proliferation of fibroblasts [2,3].

How is Tolosa-Hunt syndrome treated?

Corticosteroids are the treatment of choice for Tolosa-Hunt syndrome (THS), usually providing significant pain relief within 24–72 hours of therapy initiation.

Is Tolosa-Hunt syndrome curable?

Typically, the prognosis for Tolosa-Hunt syndrome is considered good. Patients usually respond to corticosteroids, and spontaneous remission can occur, although permanent ocular motor deficits may remain. Relapse can occur in as many as 40% of patients successfully treated for Tolosa-Hunt syndrome.

How long does Tolosa-Hunt syndrome last?

The features of THS are caused by inflammation of the cavernous sinus (an area at the base of the brain) but the underlying cause of the inflammation is unknown. Left untreated, symptoms may resolve spontaneously after an average of about eight weeks.

What is the ICD 10 code for Tolosa-Hunt syndrome?

ICD-10 for Tolosa Hunt Syndrome is H49. 40.

What is superior orbital fissure syndrome?

The superior orbital fissure syndrome (SOFS) is a complex of impaired function of the cranial nerves (III, IV, V, and VI) that enter the orbit through the superior orbital fissure (SOF). Three major precipitating factors for SOFS are trauma, tumor, and inflammation.

What nerves go through the superior orbital fissure?

Numerous structures pass through the SOF: the oculomotor (III) and trochlear nerves (IV), the ophthalmic division of the trigeminal nerve (VI) with its frontal, lacrimal, and nasociliary branch, the abducens nerve (VI), and both the ophthalmic veins, superior and inferior.

What is the role of superior orbital fissure?

Function. The superior orbital fissure functions as a bony aperture through which many important structures pass from the brain into the orbit.

What is orbital fissure syndrome?

Disease. Superior orbital fissure syndrome (also known as Rochen-Duvigneaud syndrome) is a collection of symptoms caused by compression of structures just anterior to the orbital apex.

What is the pathophysiology of Tolosa Hunt syndrome?

Tolosa-Hunt Syndrome 1 Background. Tolosa-Hunt syndrome (THS) is a painful ophthalmoplegia caused by nonspecific inflammation of the cavernous sinus or superior orbital fissure. 2 Pathophysiology. 3 Epidemiology.

What is Tolosa-Hunt syndrome (THS)?

Background. Tolosa-Hunt syndrome (THS) is a painful ophthalmoplegia caused by nonspecific inflammation of the cavernous sinus or superior orbital fissure. In 2004, the International Headache Society provided a definition of the diagnostic criteria which included granuloma. [1] See the image below. MRI of a 40-year-old man with severe periorbital…

What is the ICHD-3 diagnostic criteria for Tolosa Hunt syndrome?

ICD-10 for Tolosa Hunt Syndrome is H49.40. Unilateral orbital or periorbital pain with paresis of third, fourth and/or VIth cranial nerves secondary to idiopathic inflammation of the cavernous sinus, superior orbital fissure or orbit. The ICHD-3 Diagnostic criteria for Tolosa-Hunt syndrome are as follows :

What are the treatment options for Tolosa Hunt syndrome?

Treatment may include use of glucocorticoids or other immunosuppressive therapies. [1] Left untreated, symptoms may resolve spontaneously after an average of about eight weeks. Glucocorticoids have long been the recommended treatment for Tolosa Hunt syndrome.