Tolosa–Hunt syndrome

Abstract

A description of a clinical case of Tolosa–Hunt syndrome (THS) and a brief review of the literature are presented. The described clinical case is characterized by three features that have not received sufficient attention in the literature: 1) the presence of recurrent pain outside the orbit in combination with ptosis without diplopia several years before the development of a typical episode of THS; 2) insufficient and unstable clinical response to standard doses of glucocorticoids with high efficiency of pulse therapy with methylprednisolone followed by oral administration of prednisolone; 3) a longer than required according to the international classification of headaches (ICHD-3) time interval between the development of cephalalgia and the appearance of oculomotor disorders. This clinical observation expands the understanding of the clinical picture and treatment of THS.