Recurrent Tolosa-Hunt syndrome in a child : A Case Report
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Tolosa-Hunt Syndrome (THS) is characterized by painful ophthalmoplegia caused by nonspecific granulomatous inflammation in the cavernous sinus. It shows a prompt response to steroids. However, there is a lack of data regarding the recurrence of THS and no guidelines yet exist for the optimal duration of steroid therapy, especially in children. A 6-year-old boy with headache, ptosis, and oculomotor palsy visited the pediatric emergency room with no other evidence which could account for the etiology of disease in terms of clinical symptoms or laboratory data. Upon brain magnetic resonance imaging (MRI), multiple small-sized enhancing nodules were observed around the left cavernous sinus. He improved with prednisolone treatment. Six months later, his painful ophthalmoplegia relapsed; however, no progressive lesion was visible on the brain MRI, and the symptoms were relieved by repeated steroid therapy. Herein, we report a case of recurrent pediatric Tolosa-Hunt syndrome, which is rare in Korea.
Abstract
Tolosa-Hunt Syndrome (THS) is characterized by painful ophthalmoplegia caused by nonspecific granulomatous inflammation in the cavernous sinus. It shows a prompt response to steroids. However, there is a lack of data regarding the recurrence of THS and no guidelines yet exist for the optimal duration of steroid therapy, especially in children. A 6-year-old boy with headache, ptosis, and oculomotor palsy visited the pediatric emergency room with no other evidence which could account for the etiology of disease in terms of clinical symptoms or laboratory data. Upon brain magnetic resonance imaging (MRI), multiple small-sized enhancing nodules were observed around the left cavernous sinus. He improved with prednisolone treatment. Six months later, his painful ophthalmoplegia relapsed; however, no progressive lesion was visible on the brain MRI, and the symptoms were relieved by repeated steroid therapy. Herein, we report a case of recurrent pediatric Tolosa-Hunt syndrome, which is rare in Korea.
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