Abstract
Background: Tolosa Hunt syndrome (THS) is an uncommon case defined as unilateral orbital or periorbital pain associated with weakness of one or more of the third, fourth and/or sixth cranial nerves, the etiology is still unknown. Pain and paresis Tolosa-Hunt syndrome is cured when adequately treated with corticosteroids
 Case: We present a case of young female patient with reccurent painful opthalmoplegia since 2 years ago. She also had ptosis and protopsis on her left eye. Contrast Ct scan showed thick lateral rectus muscle and superior rectus muscle. The diagnosis of Tolosa Hunt Syndrome was made according to clinical features, contrast Ct scan of the head and a positive response to corticosteroid treatment.
 Conclusions: Tolosa Hunt Syndrome is a diagnosis of exclusion. Clinical Features, Neuroimaging, and positive response to corticosteroid treatment are very helpful in determining the diagnosis. Patient must be told that the disease can recur.
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