Tolosa-Hunt syndrome

Last reviewed 07/2021

Tolosa-Hunt Syndrome is a painful unilateral ophthalmoplegia caused by a granulomatous infiltration of nerves and muscles in the region of the superior orbital fissue. It is accompanied by partial or complete lesions of the third, fourth, fifth - ophthalmic division - and sixth cranial nerves. The ESR is usually raised.

Treatment with steroids e.g. prednisolone is usually effective.

Tolosa-Hunt syndrome should be distinguished from orbital granuloma, a mucocoele or carcinoma of the paranasal sinus, and the Miller-Fisher syndrome.