A case of atypical Tolosa-Hunt syndrome with a contrast enhanced lesion of the oculomotor and trigeminal nerves on MRI

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  • Yamamoto Daisuke
    Department of Neurology, Sapporo Medical University School of Medicine
  • Tsuda Emiko
    Department of Neurology, Sapporo Medical University School of Medicine
  • Saitoh Masaki
    Department of Neurology, Sapporo Medical University School of Medicine
  • Imai Tomihiro
    Department of Occupational Therapy, Sapporo Medical University School of Health Sciences
  • Shimohama Shun
    Department of Neurology, Sapporo Medical University School of Medicine

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Other Title
  • 造影MRIで左動眼神経と三叉神経に造影効果をみとめた非典型Tolosa-Hunt症候群の1例
  • ゾウエイ MRI デ サドウガン シンケイ ト サンサ シンケイ ニ ゾウエイ コウカ オ ミトメタ ヒテンケイ Tolosa-Hunt ショウコウグン ノ 1レイ

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Abstract

A 30-year-old woman was admitted to our hospital because of intractable orbital pain and ptosis on the left side. On admission, she had left oculomotor, ophthalmic and maxillary nerves palsy. MRI revealed a contrast enhanced lesion of the left oculomotor and trigeminal nerves through the covernous sinus and orbita. We diagnosed her condition as Tolosa-Hunt syndrome. The orbital pain was resolved within 48-hours by the pulse therapy with intra-venous methylpredonisolone. The cranial nerve palsy was gradually improved, but never reached complete remission. The left oculomotor and trigeminal nerves also remained enhanced on MRI until 200 days from the onset. Although there have been few reports to demonstrate the contrast enhancement of cranial nerves in Tolosa-Hunt syndrome, these MRI findings may be a specific indicator of the pathological process.

Journal

  • Rinsho Shinkeigaku

    Rinsho Shinkeigaku 54 (11), 903-906, 2014

    Societas Neurologica Japonica

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