Une exophtalmie révélant un syndrome d’associé Tolosa-Hunt

Published on Dec 1, 2010in Revue Neurologique1.911
· DOI :10.1016/J.NEUROL.2010.07.013
K. Ben Abdelghani1
Estimated H-index: 1
,
L. Baili1
Estimated H-index: 1
+ 2 AuthorsA. Kheder11
Estimated H-index: 11
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Abstract
References13
Newest
#1B. SchuknechtH-Index: 1
#2Veit Sturm (UZH: University of Zurich)H-Index: 16
Last. Klara Landau (UZH: University of Zurich)H-Index: 26
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Abstract Purpose (a) To assess MR features in patients with Tolosa-Hunt syndrome (THS) and to (b) correlate MR findings with criteria derived from previously reported pathologic observations. Methods Fifteen patients with twenty episodes of painful ophthalmoplegia prospectively selected according to International Headache Society (IHS) standards underwent MR examinations focused on the cavernous sinus. Initial examinations in 20 and follow-up MR images in 17 episodes were retrospectively reviewe...
76 CitationsSource
#1Rajeev Jain (Sultan Qaboos University)H-Index: 8
#2S Sawhney (Sultan Qaboos University)H-Index: 1
Last. Pratap Chand (Sultan Qaboos University)H-Index: 6
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Summary A review of MRI findings in seven patients with Tolosa–Hunt syndrome was carried out. Seven patients presented with unilateral painful ophthalmoplegia. Magnetic resonance imaging studies were carried out to evaluate the cavernous sinuses and orbits. Coronal fast spin-echo T2-weighted images and fat-saturated T1-weighted coronal and transverse images with and without contrast enhancement were obtained for the cavernous sinuses and orbits. All patients showed focal-enhancing masses expandi...
63 CitationsSource
#1Silvia Colnaghi (UNIPV: University of Pavia)H-Index: 14
#2Maurizio Versino (UNIPV: University of Pavia)H-Index: 21
Last. Giuseppe Nappi (UNIPV: University of Pavia)H-Index: 75
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A bibliographical search was conducted for papers published between 1999 and 2007 to verify the validity of International Classification of Headache Disorders (ICHD)-II criteria for the Tolosa-Hunt syndrome (THS) in terms of (i) the role of magnetic resonance imaging (MRI); (ii) which steroid treatment should be considered as adequate; and (iii) the response to treatment. Of 536 articles, 48, reporting on 62 patients, met the inclusion criteria. MRI was positive in 92.1% of the cases and it norm...
109 CitationsSource
The differential diagnosis of painful ophthalmoplegia is extensive and consists of numerous sinister etiologies, including neoplasms (ie, primary intracranial tumors, local or distant metastases), vascular (eg, aneurysm, carotid dissection, and carotid-cavernous fistula), inflammatory (ie, orbital pseudotumor, giant cell arteritis, sarcoidosis, and Tolosa-Hunt syndrome), and infectious etiologies (ie, fungal and mycobacterial), as well as other miscellaneous conditions (ie, ophthalmoplegic migra...
31 CitationsSource
#2Florensa JH-Index: 1
Last. Alvarez-Tejerina AH-Index: 4
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Introduccion. El sindrome de Tolosa-Hunt esta causado por una inflamacion inespecifica en el seno cavernoso o fisura orbitaria superior. La recidiva ocurre en un 40% de los casos. La resonancia magnetica (RM) cerebral y la flebografia orbitaria pueden mostrar datos caracteristicos, aunque el diagnostico es de exclusion, segun los criterios de la International Headache Society. Los corticoides son el tratamiento de eleccion, ya que producen la desaparicion de la clinica en pocos dias. Casos clini...
14 CitationsSource
#2Igor SibonH-Index: 25
Last. François TisonH-Index: 51
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Tolosa-Hunt syndrome (THS) is a rare cause of painful ophtalmoplegia due to chronic granulomatous inflammation of the cavernous sinus. While corticoids are the treatment of reference, corticodependence and corticoresistance are frequent, hence radiotherapy has been proposed as an alternative treatment. We report a case of long-term improvement (8 years) of THS after low-dose (20 Gy) radiotherapy in a patient with recurrences and corticodependence.
15 CitationsSource
Defining the syndrome The syndrome of painful ophthalmoplegia consists of periorbital or hemicranial pain, combined with ipsilateral ocular motor nerve palsies, oculosympathetic paralysis, and sensory loss in the distribution of the ophthalmic and occasionally the maxillary division of the trigeminal nerve. Various combinations of these cranial nerve palsies may occur, localising the pathological process to the region of the cavernous sinus/superior orbital fissure. The constellation of findings...
256 CitationsSource
#1Enrico Tessitore (Seconda Università degli Studi di Napoli)H-Index: 3
#2Alessandro Tessitore (Seconda Università degli Studi di Napoli)H-Index: 39
The Tolosa-Hunt syndrome consists of a painful ophthalmoplegia related to a granulomatous inflammatory process in the cavernous sinus, which may be documented by cerebral magnetic resonance imaging with gadolinium enhancement. Two cases of Tolosa-Hunt syndrome preceded by facial palsy observed in 1998 at the Department of Neurosurgery of the Second University of Naples are presented here. Both patients developed Tolosa-Hunt syndrome following an ipsilateral facial palsy that resolved in about 15...
54 CitationsSource
In 1988 the International Headache Society defined the diagnostic criteria of Tolosa-Hunt syndrome (THS) to include episode(s) of unilateral orbital pain for an average of 8 weeks if untreated, with associated paresis of one or more of the third, fourth, and sixth cranial nerves. Cranial nerve paresis may coincide with the onset of pain or follow it within a period of up to 2 weeks, and the pain must be relieved within 72 h after the initiation of corticosteroid therapy. Other causative lesions ...
49 CitationsSource
#1David M. Yousem (HUP: Hospital of the University of Pennsylvania)H-Index: 66
#2Scott W. Atlas (UPenn: University of Pennsylvania)H-Index: 36
Last. Thomas M. Bosley (UPenn: University of Pennsylvania)H-Index: 59
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The Tolosa-Hunt syndrome consists of painful ophthalmoplegia caused by cavernous sinus inflammation, which is responsive to steroid therapy. The MR features of 11 patients with the clinical diagnosis of Tolosa-Hunt syndrome were studied. Two patients had normal MR studies of the orbit and cavernous sinuses. In nine patients, abnormal signal and/or mass lesions were seen in the cavernous sinuses; in eight cases, the abnormality was hypointense relative to fat and isointense with muscle on short T...
93 CitationsSource
Cited By2
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view all 4 authors...
Background. Tolosa-Hunt syndrome (THS) is an uncom- mon disease caused by non-specific inflammation of the cav- ernous sinus, superior orbital fissure and the apex of the or- bit. The disease is characterized by periorbital pain, paresis of the bulbomotor and quick response to steroid treatment. The orbital process may lead to optic nerve atrophy. According to the International Headache Society Classification of 2004, the diagnostic protocol includes magnetic resonance imaging (MRI) and biopsy. ...
#1Jelena PaovicH-Index: 4
#2Predrag PaovicH-Index: 4
Last. Vojislav SredovicH-Index: 3
view all 5 authors...
Background. Tolosa-Hunt syndrome (THS) is an uncommon disease caused by non-specific inflammation of the cavernous sinus, superior orbital fissure and the apex of the orbit. The disease is characterized by periorbital pain, paresis of the bulbomotor and quick response to steroid treatment. The orbital process may lead to optic nerve atrophy. According to the International Headache Society Classification of 2004, the diagnostic protocol includes magnetic resonance imaging (MRI) and biopsy. Case r...
7 CitationsSource