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Hemifacial Pain Accompanied with Delayed Ipsilateral Abducens Nerve Palsy: Tolosa-Hunt Syndrome -A case report-  

Shim, Jae Kwang (Department of Anesthesiology and Pain Medicine Yonsei University College of Medicine)
Moon, Jin Cheon (Department of Anesthesiology and Pain Medicine Yonsei University College of Medicine)
Yoon, Kyung Bong (Department of Anesthesiology and Pain Medicine Yonsei University College of Medicine)
Kim, Won Oak (Department of Anesthesiology and Pain Medicine Yonsei University College of Medicine)
Yoon, Duck Mi (Department of Anesthesiology and Pain Medicine Yonsei University College of Medicine)
Publication Information
The Korean Journal of Pain / v.19, no.1, 2006 , pp. 104-106 More about this Journal
Abstract
Tolosa-Hunt syndrome is a rare self-limiting disease that's characterized by painful ophthalmoplegia. It has a relapsing and remitting course, and the pain responds promptly to systemic corticosteroid therapy. Yet it is diagnosed by the exclusion of other major causes involving the superior orbital fissure or cavernous sinus, including trauma, neoplasm, aneurysm and inflammation. Further, the associated ophthalmoplegia may follow days to weeks after the onset of orbital or hemifacial pain. Hence, this condition is often misdiagnosed as atypical facial pain, and so improper management could result in unnecessary suffering of the patient. The following case describes a patient suffering with hemifacial pain associated with ipsilateral abducens nerve palsy, which was evident 2 weeks after the onset of pain, and this was misdiagnosed as trigeminal neuralgia and atypical facial pain.
Keywords
hemifacial pain; ophthalmoplegia; orbital pain; Tolosa-Hunt syndrome;
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