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Painful Ophthalmoplegia
Tolosa-Hunt Syndrome

Images

WIKIDATA, CC BY 2.0

Presentation

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]

Entire Body System

  • Sulfur Granules

    These tests demonstrated acute inflammation and sulfur granules, which responded clinically and radiologically to parenterally administered penicillin therapy. [ncbi.nlm.nih.gov]

Face, Head & Neck

  • Sinus Pain

    sinus, Painful ophthalmoplegia, Tolosa-Hunt syndrome", author = "M. [moh-it.pure.elsevier.com]

Neurologic

  • Pyramidal Tract Signs

    However, during his hospitalization he developed involvement of cranial nerves II, III, V, VI and VII, papilledema, pyramidal tract signs and severe psychiatric disturbances, all of which remitted. [ncbi.nlm.nih.gov]

Workup

- 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]

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]

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]

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]

For any patient who develops signs of aberrant regeneration, workup for a structural lesion is initiated, or repeated if previous workup has been carried out and no lesion found. Nonisolated Cranial Neuropathies MULTIPLE CRANIAL NEUROPATHIES. [medtextfree.wordpress.com]

Microbiology

  • Aspergillus Niger

    A case of painful ophthalmoplegia due to invasive aspergillosis caused by Aspergillus niger in a diabetic patient is presented. [ncbi.nlm.nih.gov]

Treatment

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]

[citation needed]Sometimes a biopsy may need to be obtained to confirm the diagnosis, as it is useful in ruling out a neoplasm.[3] Other diagnoses to consider include craniopharyngioma, migraine and meningioma.[3] Treatment[edit] Treatment of Tolosa–Hunt [en.wikipedia.org]

Prognosis

[edit] The prognosis of Tolosa–Hunt syndrome is usually considered good. [en.wikipedia.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]

Etiology

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]

Pain/etiology Abstract Progressive, painful ophthalmoplegia developed in a 34-year-old man. [collections.lib.utah.edu]

Epidemiology

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 Tolosa–Hunt syndrome experience a relapse.[3] Epidemiology[edit [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

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]

Prevention

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]

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