Angiographic findings in the Tolosa-Hunt syndrome: painful ophthalmoplegia.

Abstract

The Tolosa-Hunt syndrome consists of recurrent, unilateral painful ophthalmoplegia which responds dramatically to systemic steroid therapy. The etiology appears to be a nonspecific inflammation in the cavernous sinus and superior orbital fissure. We reviewed 14 previously reported cases and describe 3 additional patients. Orbital venography, performed for the first time in these patients, demonstrated complete .ipsilateral occlusion of the superior ophthalmic vein and at least partial obliteration of the cavernous sinus. Although these venographic abnormalities are not specific, the diagnosis of Tolosa-Hunt syndrome should be suggested when they are found in patients with painful ophthalmoplegia alleviated by steroids.