Summary
The Tolosa-Hunt syndrome (THS) is characterized by remittent and sometimes recurring episodes of painful ophthalmoplegia. The etiopathogenesis is still unclear and is an object of controversy. A non-specific granulomatous process of the wall of the cavernous sinus is claimed by many authors as the possible cause, on the basis of a few pathological studies. Other authors suggest the possible role of autoimmune or specific inflammatory processes localized in the retroorbital perineural tissues.
The clinical, laboratory and radiological findings of the eight cases reported are in agreement with those previously described in the literature. However, the visual evoked potentials (VEP) were delayed in three of the four cases in which they had been studied.
This finding, together with the observation that some analogies exist between THS and other well known neuritic processes of the cranial nerves, may suggest that at least in some cases THS may be related to an ocular polyneuritis.
Zusammenfassung
Das Tolosa-Hunt-Syndrom ist charakterisiert durch gelegentlich rezidivierende Episoden von völlig rückbildungsfähiger schmerzhafter Ophthalmoplegie. Die Pathogenese ist immer noch umstritten. Manche Autoren nehmen als Ursachen einen unspezifischen granulomatösen Prozeß in der Wand des Sinus cavernosus an, gestützt auf einige wenige pathologischanatomische Untersuchungen. Andere Autoren erwägen die Rolle von Autoimmunvorgängen oder spezifischen Entzündungsprozessen im Bereiche des retroorbitalen, perineuralen Gewebes.
Es werden die Klinik, die Laboratoriums- und die Röntgenbefunde in 8 Fällen geschildert. Diese stimmen mit früheren Darlegungen in der Literatur überein. Darüber hinaus waren in 3 von 4 darauf hin untersuchten Fällen die visuell evozierten Potentiale verzögert.
Dieser Befund zusammen mit der Feststellung, daß gewisse Analogien zwischen dem Tolosa-Hunt-Syndrom und anderen neuritischen Prozessen der Hirnnerven bestehen, könnte bedeuten, daß zumindest in einzelnen Fällen von Tolosa-Hunt-Syndrom es sich um eine „oculäre Polyneuritis“ handeln könnte.
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Inzitari, D., Sità, D., Marconi, G.P. et al. The Tolosa-Hunt syndrome: Further clinical and pathogenetic considerations based on the study of eight cases. J Neurol 224, 221–228 (1981). https://doi.org/10.1007/BF00313284
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DOI: https://doi.org/10.1007/BF00313284