What is painful ophthalmoplegia?
Painful ophthalmoplegia refers to a multiple cranial nerve syndrome involving oculomotor, trochlear, abducens, and ophthalmic division of the trigeminal nerve. Among various etiologies of painful ophthalmoplegias, Tolosa-Hunt syndrome, a relatively benign condition, used to be a diagnosis of exclusion.
How is Tolosa-Hunt syndrome diagnosed?
Tolosa Hunt syndrome is diagnosed through the clinical presentation, neuroimaging studies, and response to steroids. Laboratory tests and cerebrospinal fluid (CSF) studies are supportive tests but help in ruling out other causes of ophthalmoplegia.
How is Tolosa-Hunt syndrome treated?
Corticosteroids are the treatment of choice for Tolosa-Hunt syndrome (THS), usually providing significant pain relief within 24–72 hours of therapy initiation.
How long does Tolosa-Hunt syndrome last?
Clinical profile of Tolosa-Hunt syndrome The pain lasts an average of 8 weeks if untreated. Ocular motor cranial nerve palsies may coincide with the onset of pain or follow it within a period of up to 2 weeks. 20 It is usually described as “intense”, “severe”, “boring”, “lancinating”, or “stabbing”.
What are symptoms of Tolosa-Hunt syndrome?
The major symptoms of Tolosa-Hunt syndrome include chronic periorbital headache, double vision, paralysis (palsy) of certain cranial nerves, and chronic fatigue. Affected individuals may also exhibit protrusion of the eye (proptosis), drooping of the upper eyelid (ptosis) and diminished vision.
What is orbital apex syndrome?
Orbital apex syndrome (OAS) involves cranial neuropathies in association with optic nerve dysfunction. Orbital apex syndrome is symptomatically related to superior orbital fissure syndrome and cavernous sinus syndrome with similar etiologies. The distinction is the precise anatomic involvement of the disease process.
Is Tolosa-Hunt syndrome serious?
Typically, the prognosis for Tolosa-Hunt syndrome is considered good. Patients usually respond to corticosteroids, and spontaneous remission can occur, although permanent ocular motor deficits may remain. Relapse can occur in as many as 40% of patients successfully treated for Tolosa-Hunt syndrome.
What is gradenigo syndrome?
Gradenigo Syndrome (GS) is classically described as a clinical triad of otitis media, facial pain, and abducens palsy that in the past most commonly developed from infection in the petrous temporal bone (i.e., petrous apicitis).
What is CPEO?
Chronic progressive external ophthalmoplegia (CPEO) describes an array of hereditary myopathies affecting extraocular muscles (EOMs), commonly manifesting as bilateral ptosis and ophthalmoplegia.
What is Petrositis?
Petrositis most often refers to infection of the petrous portion of the temporal bone, the bone in the skull that surrounds the ear. This infection goes deep to the inner ear. It is sometimes associated with otitis media (a middle ear infection).
What is Vernet’s syndrome?
Vernet syndrome refers to paralysis of the IX, X, and XI cranial nerves traversing the jugular foramen. A variety of lesions can involve the jugular foramen, such as tumors, vascular lesions, infections, and trauma .
How is Glossopharyngeal neuralgia diagnosed?
Diagnosis of Glossopharyngeal Neuralgia For the test, a doctor touches the back of the throat with a cotton-tipped applicator. If pain results, the doctor applies a local anesthetic to the back of the throat. If the anesthetic eliminates the pain, glossopharyngeal neuralgia is likely.
What is Intorsion of the eye?
Superior Oblique (SO) Rotates the top of the eye towards the nose (intorsion) Moves the eye downwards (depression) Moves the eye outwards (abduction)
What causes petrous Apicitis?
Petrous apicitis may follow an acute or a chronic course. The acute form typically develops rapidly and is caused by sudden obstruction of a normally pneumatized petrous apex air cell system. This obstruction can be caused by mechanical blockage from a lesion within the mastoid or by acute mastoid inflammation.
Does amoxicillin treat otitis media?
According to the CDC report, amoxicillin remains the initial drug of choice for the treatment of acute otitis media. Higher dosages of amoxicillin (80 mg per kg per day rather than the usual 40 mg per kg per day) are recommended to address the issue of penicillin-resistant pneumococci.