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Tolosa-hunt syndrome versus recurrent cranial neuropathy

Report of two cases with a prolonged follow-up

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Summary

Two patients are described who had suffered for 12 years from episodes of painful ophthalmoplegia consistent with a Tolosa-Hunt syndrome (THS) alternating with palsies of cranial nerves other than the oculomotor (fifth motor and seventh on both sides). These two cases, as well as other similar ones previously reported in the literature, suggest that THS may sometimes be a variant of so-called recurrent cranial neuropathy, which is a benign and poorly understood clinical entity on an inflammatory or ischaemic basis.

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References

  1. Adams AH, Warner AW (1975) Painful ophthalmoplegia. Report of a case with cerebral involvement and psychiatric complications. Bull Los Ang Neurol Soc 40:49–55

    Google Scholar 

  2. Asbury AK, Arnason BG, Karp HR, McFarlin DE (1978) Criteria for diagnosis of Guillain-Barré syndrome. Ann Neurol 3:565–566

    Google Scholar 

  3. Barontini F, Sità D (1983) The nosologic position of Fisher's syndrome (ophthalmoplegia, ataxia and areflexia). J Neurol 229:33–44

    Google Scholar 

  4. Barricks ME, Traviesa DB, Glaser JS, Levy IS (1977) Ophthalmoplegia in cranial arteritis. Brain 100:209–221

    Google Scholar 

  5. Cohn DF, Carasso R, Streifler M (1979) Painful ophthalmoplegia: the Tolosa-Hunt syndrome. Eur Neurol 18:373–381

    Google Scholar 

  6. Fowler TJ, Earl CJ, McAllister VL, McDonald WK (1975) Tolosa-Hunt syndrome: the danger of an eponym. Br J Ophthalmol 59:149–154

    Google Scholar 

  7. Glaser JS (1978) Neuro-ophthalmology. Harper and Row, Hagerstown

    Google Scholar 

  8. Hokkanen E, Haltia T, Myllyla VV (1978) Recurrent multiple cranial neuropathies. Eur Neurol 17:32–37

    Google Scholar 

  9. Hunt WE, Maegher JN, LeFever HE, Zeman W (1961) Painful ophthalmoplegia. Its relation to indolent inflammation of the cavernous sinus. Neurology 11:56–62

    Google Scholar 

  10. Inzitari D, Sità D, Marconi GF, Barontini F (1981) The Tolosa-Hunt syndrome: further clinical and pathogenetic considerations based on the study of eight cases. J Neurol 224:221–228

    Google Scholar 

  11. Kandt RS, Goldstein W (1985) Steroid-responsive ophthalmoplegia in a child. Diagnostic considerations. Arch Neurol 42:589–591

    Google Scholar 

  12. Kline LB (1982) The Tolosa-Hunt syndrome. Surv Ophthalmol 27:79–95

    Google Scholar 

  13. Kreindler A, Macovei-Patrichi M (1968) Recurrent cranial nerve palsy of dysglobulinemic origin. J Neurol Sci 6:117–123

    Google Scholar 

  14. Lakke JP (1962) Superior orbital fissure syndrome: report of a case caused by local pachymeningitis. Arch Neurol 7:289

    Google Scholar 

  15. Lapresle J, Lasjaunias P (1986) Cranial nerve ischaemic arterial syndromes. A review. Brain 109:207–215

    Google Scholar 

  16. Leigh RJ, Zee DS (1983) The neurology of eye movements. Davis, Philadelphia

    Google Scholar 

  17. Mathew NT, Chandy J (1970) Painful ophthalmoplegia. J Neurol Sci 11:243–256

    Google Scholar 

  18. Nagaraja D, Suresh TG (1984) Painful ophthalmoplegia. An analysis of 50 cases. Neurol India 32:21–24

    Google Scholar 

  19. Ratnavale G (1968) Cranial polyneuritis. A distinct clinical entity. Proc Aust Assoc Neurol 5:527–529

    Google Scholar 

  20. Ross AT (1962) Recurrent cranial nerve palsies in diabetes mellitus. Neurology 12:180–185

    Google Scholar 

  21. Schatz JN, Farmer P (1972) Tolosa-Hunt syndrome: the pathology of painful ophthalmoplegia. In: Smith JL (ed) Neuro-ophthalmology Symposium of the University of Miami and the Bascon Palmer Eye Institute, vol VI. Mosby, St Louis, pp 102–112

    Google Scholar 

  22. Smith JL, Taxdal D (1966) Painful ophthalmoplegia: the Tolosa-Hunt syndrome. Am J Ophthalmol 61:1466–1472

    Google Scholar 

  23. Sondheimer FK, Knapp J (1973) Angiographic findings in the Tolosa — Hunt syndrome-painful ophthalmoplegia. Radiology 106:105

    Google Scholar 

  24. Spector RH, Fiandaca MS (1986) The “sinister” Tolosa-Hunt syndrome. Neurology 36:198–203

    Google Scholar 

  25. Steele JC, Vasuvat A (1970) Recurrent multiple cranial nerve palsies: a distinctive syndrome of cranial polyneuropathy. J Neurol Neurosurg Psychiatry 33:828–832

    Google Scholar 

  26. Swerdlow B (1980) Tolosa-Hunt syndrome: a case with associated facial nerve palsy. Ann Neurol 8:542–543

    Google Scholar 

  27. Symonds C (1958) Recurrent multiple cranial nerve palsies. J Neurol Neurosurg Psychiatry 21:95–100

    Google Scholar 

  28. Takahashi A (1978) Migrating disseminated multiple cranial neuropathy. Clin Neurol 14:843

    Google Scholar 

  29. Tolosa E (1954) Periarteritic lesion of the carotid syphon with the clinical features of a carotid infraclinoidal aneurysm. J Neurol Neurosurg Psychiatry 17:300–302

    Google Scholar 

  30. Vallat JM, Vallat M, Julien J, Dumas M, Dany A (1980) Painful ophthalmoplegia (Tolosa-Hunt) accompanied by peripheral facial paralysis. Ann Neurol 8:645

    Google Scholar 

  31. Van Bogaert L, Maere M (1938) Les polyradiculonevrites crâniennes bilaterales avec dissociation albumino-cytologique. Forme crânienne des polyradiculonevrites type Guillain-et-Barré. J Belg Neurol Psychiatry 38:275–281

    Google Scholar 

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Barontini, F., Maurri, S. & Marrapodi, E. Tolosa-hunt syndrome versus recurrent cranial neuropathy. J Neurol 234, 112–115 (1987). https://doi.org/10.1007/BF00314114

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  • DOI: https://doi.org/10.1007/BF00314114

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