Tolosa Hunt Syndrome

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Classification according to ICD-10
H49.0 Paralysis of the oculomotor nerve [III. Cranial nerve]
ICD-10 online (WHO version 2019)


As Tolosa-Hunt syndrome , also ophthalmoplegia dolorosa , painful ophthalmoplegia , one is painful paralysis of the eye muscles referred for the first time in 1954 by the Spanish neurosurgeons Eduardo Tolosa (1900-1981) and in 1961 American US from his colleagues William Edward Hunt (1921- 1999). The term Tolosa Hunt Syndrome was coined by J. Lawton Smith and David SR Taxdal in 1966.

Patients complain of severe pain behind the eye . In addition, paralysis of the eye muscles supplied by the oculomotor nerve , trochlear nerve and abducens nerve occur on the same side . Other cranial nerves can also be affected.

It is based on a chronic granulomatous inflammation in the area of ​​the so-called orbital tip or behind the orbit (eye socket) in the vicinity of the superior orbital fissure or the cavernous sinus , a network of venous blood vessels . The cause of this inflammation is unknown. Corticoids are used for treatment . The prognosis is favorable and spontaneous remissions are possible; however, recurrences can also occur. The diagnosis requires the reliable exclusion of possible other diseases that may be associated with similar symptoms, such as tumors, trauma or an aneurysm . A diagnostic imaging is necessary in any case.

See also

Web links

literature

  • P. Schramm, S. Hähnel: The Tolosa Hunt Syndrome - a neuroradiological diagnosis of exclusion? Fortschr Röntgenstr 2001; 173 (10): 962-964 DOI: 10.1055 / s-2001-17580
  • LB Kline: The Tolosa-Hunt syndrome. In: Journal of Neurology, Neurosurgery & Psychiatry. 71, p. 577, doi : 10.1136 / jnnp.71.5.577 .

Individual evidence

  1. ↑ Alphabetical directory for the ICD-10-WHO version 2019, volume 3. German Institute for Medical Documentation and Information (DIMDI), Cologne, 2019, p. 877
  2. ^ Eduardo Tolosa: Periarteritic lesions of the carotid siphon with the clinical features of a carotid infraclinoidal aneurysm. In: Journal of Neurology, Neurosurgery, and Psychiatry . Volume 17, number 4, November 1954, pp. 300-302, doi : 10.1136 / jnnp.17.4.300 , PMID 13212421 , PMC 503202 (free full text).
  3. ^ William E. Hunt, John N. Meagher, Harry E. LeFever, Wolfgang Zeman: Painful opthalmoplegia. Its relation to indolent inflammation of the carvernous sinus. In: Neurology . Vol. 11, No. 1, January 1961, ISSN  0028-3878 , pp. 56-62, PMID 13716871 , online .
  4. ^ J. Lawton Smith, David SR Taxdal: Painful Ophthalmoplegia. The Tolosa-Hunt syndrome. In: American Journal of Ophthalmology. Volume 61, No. 6, June 1966, pp. 1466-1472, doi: 10.1016 / 0002-9394 (66) 90487-9 .