Perhaps it is only an occasional presentation of another rather poorly understood syndrome, that of "recurrent cranial neuropathies." The present patient had at least three episodes of painful ophthalmoplegia prior to this hospitalization. [ncbi.nlm.nih.gov]

• Hunting

  Hunt syndrome edit English tolosa-hunt syndrome Human disease Tolosa-Hunt syndrome Tolosa-Hunt syndrome (disorder) Tolosa–Hunt syndrome; THS THS Nonspecific inflammation of the cavernous sinus or superior orbital fissure Painful ophthalmoplegia Tolosa [wikidata.org]

  Tolosa–Hunt syndrome preceded by facial palsy. Headache 2000 ; 40: 393 – 6. Google Scholar | Crossref | Medline | ISI 74. Mormont, E, Laloux, P, Vauthier, J, Ossemann, M. Radiotherapy in a case of Tolosa–Hunt syndrome. [doi.org]

• Swelling

  It was accompanied by a feeling of swelling in the affected region, but not by nausea nor vomiting. Conventional headache drugs provided little relief. [ncbi.nlm.nih.gov]

  Over the next 7 days he showed a marked improvement of periorbital swelling, and limitation of the eye movement gradually improved. [thejournalofheadacheandpain.springeropen.com]

  Presentation  Unilateral presentation  Pain followed by diplopia  Proptosis/ erythema/swelling  Vision loss occassionally Work up CBC, Metabolic panel, thyroid function tests,ANCA, RA Factor  Imaging: CT scan 40.  Enlargement of the EO muscles  [slideshare.net]

  It is first described by Gleason in 1903 and clinically characterized by periorbital swelling, ptosis, proptosis and painful eye movements. [semanticscholar.org]

  Patients with fungal infection who develop sino-orbito –cerebral syndrome often present with acute headache, fever, facial swelling, sinusitis, opthalmoplegia and/or blindness. [ 4, 7 ] It is rare for individuals with mucormycosis to present with orbital [amhsr.org]

• Severe Pain

  Following this procedure she complained of non-resolving tooth pain for 10 days. Her panoramic and perialveolar dental x-rays were normal, but dental examination revealed severe pain with vertical and horizontal pressure on the tooth. [docksci.com]

  Case Report A 48-year-old Taiwanese man with hepatitis B virus (HBV)-related HCC presented to the Emergency Department with a 5-day history of gradual onset of severe boring pain at the medial side of right orbital area and double vision. [jmedscindmc.com]

  The direction of blood flow through a direct CCF may be Posterior: into the superior and inferior petrosal sinuses, or anterior: into the orbital veins (severe features) 25. [slideshare.net]

  Six days before admission, the patient awoke with severe pain radiating from the left periorbital area to the temporal region. The pain was precipitated by eye movements. [e-crt.org]

  […] by several days, or may not appear until some time later. [jnnp.bmj.com]

• Asymptomatic

  […] eye.[1] In Europe and Asia, astigmatism affects between 30 and 60% of adults.[4] People of all ages can be affected by astigmatism.[1] Astigmatism was first reported by Thomas Young in 1801.[3][5] Signs and symptoms[edit] Although astigmatism may be asymptomatic [reppeat.com]

  Common presenting symptoms include abdominal pain (20.6%), palpable lower abdominal mass (23.5%), vaginal bleeding (8.8%), or asymptomatic (41.2%, tumor discovered by routine ultrasound). [ncbi.nlm.nih.gov]

• Vomiting

  It was accompanied by a feeling of swelling in the affected region, but not by nausea nor vomiting. Conventional headache drugs provided little relief. [ncbi.nlm.nih.gov]

  During the next two days he experienced dizziness, without nausea, vomiting, headache, or visual problems. [nejm.org]

  Examples include headache, dizziness, vomiting, tachycardia, and hypertension. [smj.org.sa]

  "Sometimes, it reaches a point where I am useless for 3 days, just in bed, vomiting, and unable to move." Bukod pa rito, mas nagiging sensitive sa sound at light ang isang taong may migraine. [pep.ph]

  Nausea and vomiting are reported. [patient.info]

• Nausea

  It was accompanied by a feeling of swelling in the affected region, but not by nausea nor vomiting. Conventional headache drugs provided little relief. [ncbi.nlm.nih.gov]

  During the next two days he experienced dizziness, without nausea, vomiting, headache, or visual problems. [nejm.org]

  Nausea and vomiting are reported. [patient.info]

  The patient may complain of double vision worse at distance, headaches, dizziness, nausea, neck stiffness, photophobia, blurred vision, and a “boring” pain may be associated with the headache. [eyewiki.aao.org]

  Although rare, some patients can also refer nausea and vomiting in consequence to pain intensity. [scielo.br]

• Vascular Disease

  Cardiovascular disease Cerebrovascular disease Cerebral disorder Cranial nerve disease Oculomotor syndrome Eye disease Orbit(eye) disease Central nervous system disease Motor system disorder Neurological disorder Vascular disease Keyword (es) Cefalea [pascal-francis.inist.fr]

  With regard to etiology, inflammatory, infiltrative, neoplastic, and vascular diseases can all result in nonspecific painful ophthalmoplegia [slideshare.net]

  The condition is associated with multiple sclerosis, vascular disease, tumour of the brainstem or encephalitis. [medical-dictionary.thefreedictionary.com]

  Discussion The differential diagnosis of PO involves numerous diseases, including neoplasms (i.e., primary parasellar tumors, and local or distant metastases), vascular disease (i.e., aneurysm and carotid dissection), inflammatory disease (i.e., orbital [e-crt.org]

  If negative, CSF examination is carried out and serologic evaluation for collagen vascular disease, arteritis, syphilis, and Lyme disease is obtained. [medtextfree.wordpress.com]

• Dental Caries

  […] similar to ours, both presenting with painful ophthalmoplegia: one following extraction of a maxillary canine tooth with caries and the other following treatment for multiple dental caries and periodontitis including maxillary teeth. [docksci.com]

• Muscle Weakness

  weakness (e.g., pterygoid and masseter muscles). [eyewiki.org]

  In a patient who has a vertical deviation because of a weakness in a single muscle, this three-step test determines which muscle is weak. [medtextfree.wordpress.com]

• Alopecia

  […] areata Alopecia universalis Amyopathic Dermatomyositis Anti-synthetase syndrome Atopic allergy Atopic dermatitis Autoimmune progesterone dermatitis Autoimmune thrombocytopenic purpura Autoimmune urticaria Bechet’s syndrome Blau syndrome Bullous pemphigoid [ldnresearchtrust.org]

• Normal Hair

  Dcm presents with vaginal bleeding. approval tadalafil cialis pah europe Normal hairs viagra use longterm grow within the lumen of both blood and mucus cialis mix ecstacy membranes, caused by a distressed parent. [smj.org.sa]

• Painful Ophthalmoplegia

  Painful ophthalmoplegia in childhood has different causes. One is Tolosa-Hunt syndrome, in which a first episode may be difficult to diagnose because of its clinical similarity to ophthalmoplegic migraine. [ncbi.nlm.nih.gov]

  Table 3 Additional causes of painful ophthalmoplegia Various orbital diseases cause painful ophthalmoplegia. [jnnp.bmj.com]

  Acta Medica Croatica 61(4): 395-398, 2007 Tolosa hunt syndrome or painful ophthalmoplegia. Bollettino di Oculistica 59(1-2): 43-54, 1980 Painful ophthalmoplegia the tolosa hunt syndrome. [eurekamag.com]

• Visual Impairment

  Hannerz J, Ericson K, Bergstrand G (1986) A new etiology for visual impairment and chronic headache. The Tolosa-Hunt syndrome may be only one manifestation of venous vasculitis. Cephalalgia 6:59–63 PubMed CrossRef Google Scholar 8. [link.springer.com]

  Usually, there is no visual impairment. The treatment is based on corticosteroids with satisfactory results in most cases although recurrences can occur at intervals from months to years. [scielo.br]

• Miosis

  A) Left eye with miosis and ptosis. B) After administration of apraclonidine, there may be reversal of the anisocoria and elevation of the eyelid. [eyewiki.org]

  Home | CCC | Horner syndrome DDx Overview The features of Horner syndrome are: Mild ptosis — paresis of Müller muscle (absent on upward gaze due to intact CN3 function) Miosis — paralysis of pupillary dilator muscle Ipsilateral anhidrosis Apparent enophthalmos [litfl.com]

  The diagnosis is made by finding the other features of the near reflex, mainly miosis, on attempted lateral gaze. Ductions tested with the other eye covered usually are normal. [medtextfree.wordpress.com]

• Blepharoptosis

  The condition evolves persistently for a month, when there was partial blepharoptosis in the left eye associated to left retroorbitary pain of moderate intensity that would not decrease with the use of common analgesics. [scielo.br]

• Cranial Neuropathy

  Although the coexistence of THS and diabetic cranial neuropathy is an uncommon condition, this should be considered as a possible diagnosis on patients who are admitted with painful ophtalmoplegia and simultaneous multipl cranial neuropathies. [go.gale.com]

  Perhaps it is only an occasional presentation of another rather poorly understood syndrome, that of "recurrent cranial neuropathies." The present patient had at least three episodes of painful ophthalmoplegia prior to this hospitalization. [ncbi.nlm.nih.gov]

  This can be useful to verify the presence of an inflammatory cranial neuropathy or a Tolosa-Hunt Syndrome. [eanpages.org]

  Nonisolated Cranial Neuropathies MULTIPLE CRANIAL NEUROPATHIES. [medtextfree.wordpress.com]

• Meningism

  We report the case of a 58-year-old woman in whom relapsing painful ophthalmoplegia related to a mycetoma of the sphenoid sinus gave origin to meningitis with markedly depressed glucose levels in the cerebrospinal fluid. [ncbi.nlm.nih.gov]

  Painful ophthalmoplegia is a rare pathologic condition caused by non-specific inflammation of the cavernous sinus, but other causes such as tumours, vasculitis, basal meningitis, neurosarcoidosis, diabetes can be responsible for the syndrome. [moh-it.pure.elsevier.com]

  Consider other pathological processes presenting with similar clinical features such as meningioma, sarcoidosis, pituitary tumors, tuberculous meningitis, lymphoma. Promoted articles (advertising) [radiopaedia.org]

• Mydriasis

  We also noticed complete ptosis on the right side, and marked hypofunction in five of the six external extraocular muscles at the same side (medial rectus, superior rectus, inferior rectus, inferior oblique and superior oblique), besides, ipsilateral mydriasis [scielo.br]

  Presently, on examination, she showed an incomplete ptosis on the left with mydriasis (1mm of difference) and incomplete abduction of her left eye with horizontal diplopia which is maximal on abduction of the left eye without other signs. [eanpages.org]

  Neurologic examination revealed complete right ophthalmoplegia accompanied by pain and mydriasis, hypoalgesia in the region innervated by the first division of trigeminal nerve, diminished corneal reflex, and blindness in the right eye. [amhsr.org]

  Isolated ptosis or mydriasis usually is not a sign of third nerve palsy. When complete, the eye may be deviated down and out. [medtextfree.wordpress.com]

• Throbbing Headache

  Case Report We present the case of a 29-year-old previously healthy female who was admitted at our center with 3 days history of severe right-sided, non-throbbing headache which was continuous. There was no history of similar complains in the past. [indianjpain.org]

• Hypesthesia

  A 34-year-old man presented with a 3-month history of acute onset of left-sided retro-orbital pain that progressed to a complete left Cranial Nerve VI palsy and Cranial Nerve V1 and V2 hypesthesia. [ncbi.nlm.nih.gov]

A metastatic workup was performed without any evidence of extraorbital tumor. The patient was recommended to be treated with chemotherapy, however, refused to take the treatment. The patient died of progression of the disease in a month. [ncbi.nlm.nih.gov]

- When faced with a clinical picture suggestive of the existence of Tolosa-Hunt syndrome clinical workup is mandatory and should lead to diagnosis of exclusion. Identifiers Authors User assignment Assign yourself or invite other person as author. [infona.pl]

Ethan Sterk He is admitted to the neurology service, and subsequent workup includes the following tests: erythrocyte sedimentation rate, C-reactive protein, antinuclear antibody, antineutrophil cytoplasmic antibody, rapid plasma reagin, double-stranded [acepnow.com]

Blood and CSF workup were normal. Urgent CT angiography excluded an intracerebral aneurysm and cavernous sinus thrombosis. A repeat MRI was performed, obtaining the images below. Figure 1. MRI of the brain (A=axial view. B=coronal view). [nzma.org.nz]

However, all recruited patients had ancillary laboratory workup, cranial MR imaging, and cerebral vascular investigation. [bmcneurol.biomedcentral.com]

MRI and positive response to the treatment with corticosteroids were relevant for making the diagnosis. [ncbi.nlm.nih.gov]

While corticoids are the treatment of reference, corticodependence and corticoresistance are frequent, hence radiotherapy has been proposed as an alternative treatment. [doi.org]

Individuals usually have a very good prognosis with the condition, because steroids have been proven to be an effective treatment measure Nevertheless, complications, such as the damage and abnormal repair of the cranial nerves, can worsen the prognosis [dovemed.com]

Its recognition is important since the response to steroids, although not specific, is rapid in most patients, and the prognosis for complete recovery is relatively good. [ncbi.nlm.nih.gov]

[edit] The prognosis of THS is usually considered good. [en.wikipedia.org]

The etiological differential diagnosis of painful ophthalmoplegia is extensive and consists of numerous sinister etiologies including vascular (eg, aneurysm, carotid dissection, carotid-cavernous fistula), neoplasms (eg, primary intracranial tumors, local [ncbi.nlm.nih.gov]

Patients usually respond to corticosteroids, and spontaneous remission can occur, although movement of ocular muscles may remain damaged.[3] Roughly 30–40% of patients who are treated for THS experience a relapse.[3] Epidemiology[edit] THS is uncommon [en.wikipedia.org]

Epidemiology Frequency Tolosa-Hunt syndrome (THS) is uncommon in both the United States and internationally. The disorder is rare during the first 2 decades of life; in people older than 20 years, it appears to have an even distribution. [emedicine.com]

Pathophysiology Nonspecific inflammation (noncaseating granulomatous or nongranulomatous) within the cavernous sinus or superior orbital fissure is the cause of the constant pain, which characterizes the onset of this disorder. [emedicine.com]

One of the pathophysiologic hypothesis for the cause of ocular complications is intravenous injection of the local anaesthetic fluid.6,8,9 During anaesthesia for maxillary tooth procedures, improper size and placement of the needle can cause damage to [docksci.com]

Hernia 6(2): 64-67, 2002 Pathophysiology of groin pain in sporting patients may be more complex than the standard definition of groin hernia. [eurekamag.com]

This case highlights the importance for the Emergency Physician to quickly recognize painful ophthalmoplegia and rapidly elucidate the cause to prevent further complications for the patient. [ncbi.nlm.nih.gov]

prevention, prognosis, and additional useful information HERE. [dovemed.com]

Feeling very tired MIGRAINE prevention Knowing the symptoms and triggers, and noting the patterns can help prevent a migraine. Sa mga ladies, halimbawa, if it usually happens before the menstrual period, alamin kung may iba pang triggers. [pep.ph]

Prevention of death, myocardial infarction, and stroke by prolonged antiplatelet therapy in various categories of patients. ‎ [books.google.de]