Steroid-responsive painful ophthalmoplegia

Tolosa-Hunt syndrome, Eales disease, or both?

MD Mendonça, Marta Guedes, Gonçalo Matias, João Costa, M Viana-Baptista

Research output: Contribution to journalEditorial

1 Citation (Scopus)

Abstract

INTRODUCTION: Tolosa-Hunt syndrome (THS) is one of the most common 'benign' causes of painful ophthalmoplegia. Diagnosis is based on clinical and imaging findings and the exclusion of other causes because there is no specific biomarker for the syndrome. Eales disease, an idiopathic inflammatory venous disease that primarily affects the eye, can also affect the central (as stroke or myelitis) and peripheral nervous system.

CASE REPORT: We report the case of a 32-year-old woman with a subacute left ophthalmoplegia and evidence of a gadolinium-enhanced lesion suggesting an inflammatory granuloma that resolved within 48 hours after treatment with steroids. A diagnosis of THS was considered at this time. On a follow-up ophthalmological examination, a diagnosis of Eales disease with involvement of the left eye was made. The patient was treated successfully.

CONCLUSION: Eales disease could be a cause of painful ophthalmoplegia and may mimic THS. Long-term follow-up of patients diagnosed with THS may be necessary to exclude other diagnoses.

Original languageEnglish
Pages (from-to)191-194
Number of pages4
JournalCephalalgia
Volume37
Issue number2
Early online date11 Jul 2016
DOIs
Publication statusPublished - Feb 2017

Fingerprint

Tolosa-Hunt Syndrome
Steroids
Myelitis
Ophthalmoplegia
Peripheral Nervous System
Gadolinium
Granuloma
Biomarkers
Stroke
Painful Ophthalmoplegia
Eales disease

Keywords

  • Eales disease
  • Tolosa–Hunt syndrome
  • painful ophthalmoplegia

Cite this

Mendonça, MD ; Guedes, Marta ; Matias, Gonçalo ; Costa, João ; Viana-Baptista, M . / Steroid-responsive painful ophthalmoplegia : Tolosa-Hunt syndrome, Eales disease, or both?. In: Cephalalgia. 2017 ; Vol. 37, No. 2. pp. 191-194.
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abstract = "INTRODUCTION: Tolosa-Hunt syndrome (THS) is one of the most common 'benign' causes of painful ophthalmoplegia. Diagnosis is based on clinical and imaging findings and the exclusion of other causes because there is no specific biomarker for the syndrome. Eales disease, an idiopathic inflammatory venous disease that primarily affects the eye, can also affect the central (as stroke or myelitis) and peripheral nervous system.CASE REPORT: We report the case of a 32-year-old woman with a subacute left ophthalmoplegia and evidence of a gadolinium-enhanced lesion suggesting an inflammatory granuloma that resolved within 48 hours after treatment with steroids. A diagnosis of THS was considered at this time. On a follow-up ophthalmological examination, a diagnosis of Eales disease with involvement of the left eye was made. The patient was treated successfully.CONCLUSION: Eales disease could be a cause of painful ophthalmoplegia and may mimic THS. Long-term follow-up of patients diagnosed with THS may be necessary to exclude other diagnoses.",
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Steroid-responsive painful ophthalmoplegia : Tolosa-Hunt syndrome, Eales disease, or both? / Mendonça, MD; Guedes, Marta; Matias, Gonçalo; Costa, João; Viana-Baptista, M .

In: Cephalalgia, Vol. 37, No. 2, 02.2017, p. 191-194.

Research output: Contribution to journalEditorial

TY - JOUR

T1 - Steroid-responsive painful ophthalmoplegia

T2 - Tolosa-Hunt syndrome, Eales disease, or both?

AU - Mendonça, MD

AU - Guedes, Marta

AU - Matias, Gonçalo

AU - Costa, João

AU - Viana-Baptista, M

N1 - © International Headache Society 2016.

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AB - INTRODUCTION: Tolosa-Hunt syndrome (THS) is one of the most common 'benign' causes of painful ophthalmoplegia. Diagnosis is based on clinical and imaging findings and the exclusion of other causes because there is no specific biomarker for the syndrome. Eales disease, an idiopathic inflammatory venous disease that primarily affects the eye, can also affect the central (as stroke or myelitis) and peripheral nervous system.CASE REPORT: We report the case of a 32-year-old woman with a subacute left ophthalmoplegia and evidence of a gadolinium-enhanced lesion suggesting an inflammatory granuloma that resolved within 48 hours after treatment with steroids. A diagnosis of THS was considered at this time. On a follow-up ophthalmological examination, a diagnosis of Eales disease with involvement of the left eye was made. The patient was treated successfully.CONCLUSION: Eales disease could be a cause of painful ophthalmoplegia and may mimic THS. Long-term follow-up of patients diagnosed with THS may be necessary to exclude other diagnoses.

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