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KMID : 0857020100250020146
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Kosin Medical Journal
2010 Volume.25 No. 2 p.146 ~ p.149
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A Case of Tolosa-Hunt Syndrome Misdiagnosed as Migraine
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Yoo Jae-Ho
Kim Soo-Young
Lee Sang-Joon
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Abstract
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A case report on Tolosa-Hunt syndrome misdiagnosed as migraine. A 21 year old woman presented with persistent unilateral headache and ocular pain. She visited a general hospital with headache and ocular pain, and underwent orbital and brain magnetic resonance imaging (MRI). However, there was no significant abnormality. She was diagnosed with migraine and relied on analgesics to control pain. After 30 days, ptosis and ophthalmoplegia began to develop. Her visual acuity was decreased in left eye, associated with 3rd, 4th and 6th cranial nerve palsy. Orbital MRI showed pathologic findings in the left superior rectus muscle and the orbit. With steroid therapy, extraocular muscle movement and visual acuity in left eye was improved. High signal in the superior rectus muscle and orbit decreased in follow-up orbital MRI. Tolosa-Hunt syndrome is a rare, benign condition, which should be excluded in patients with headache. MRI is essential to diagnosis and follow-up of this condition, although not confirmatory of this disease.
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KEYWORD
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Extraocular muscles, Ophthalmoplegia, Tolosa-Hunt syndrome
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