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 journalEditorialpeer-review

2 Citations (Scopus)


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
Issue number2
Early online date11 Jul 2016
Publication statusPublished - Feb 2017


  • Eales disease
  • Tolosa–Hunt syndrome
  • painful ophthalmoplegia


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