• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.16 no.1
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• pp.220-225
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• 2003

The Tolosa-Hunt syndrome is a symptom complex with unilateral painful ophthalmoplegia associated with retro-orbital pain, proptosis and Ⅲ, Ⅳ, Ⅴ-1, Ⅵ cranial nerves palsy due to nonspecific granulomatous inflammation in the superior orbital fissure or cavernous sinus. We experienced a 50 years old female patient with Tolosa-Hunt syndrome who had several clinical signs and symptoms such as ocular pain, headache, sensory loss of face, diplopia, and visual disturbance. In the point of Differentiation of Syndrome(辨證). this subject was diagnosed as Deficiency of yin in liver and kidney(肝腎陰虛), and was administrated with Yangyeummyungmoktang-Gamibang. After treatment of acupuncture and herbal medicine above symptoms were improved.

• Journal of Acupuncture Research
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• v.18 no.5
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• pp.179-184
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• 2001

The Tolosa-Hunt syndrome(THS) consists of a painful ophthalmoplegia related to a granulomatous inflammatory process in the cavernous sinus, which may be documented by cerebral magnetic resonance imaging with gadolinium enhancement. Generally, it has been reported that 2 weeks steroid therapy relieves the symptoms(periorbital pain, ophthalmoplegia) of THS. In this case, there had been no improvement of symptoms by western medical treatments(steroid & analgesics). but, the symptoms were resolved clearly by acupuncture therapy during 6 weeks(5 times/week). If more clinical trials like this are proved to be effective in THS, we can expect that acupuncture will be another therapeutical modality in THS.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.18 no.2
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• pp.86-92
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• 2005

Painful ophthalmoplegia due to idiopathic granulomatous inflammation of the cavernous sinus/superior orbital fissure has been termed Tolosa-Hunt syndrome(THS). The syndrome is characterized by pain behind, above or around the eye, involvement of the cranial nerves which pass through the cavernous sinus, spontaneous remissions and exacerbations, and a favourable response to steroid therapy. There was the 56 years old man who suffered from painful ophthalmoplegia and facial palsy. The oriental medical treatment without steroids and analgesics reduced the symptoms of the patient remarkably during 5 weeks. There is few report that treat THS with oriental medical method. If more clinical trials like this are proved to be effective, we can expect that oriental medical treatment will be a good method in THS.

• Investigative Magnetic Resonance Imaging
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• v.23 no.2
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• pp.172-174
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• 2019

Upon review, it is noted that recurrent painful ophthalmoplegic neuropathy (RPON) is a rare neurological syndrome characterized by recurrent unilateral headaches and painful ophthalmoplegia of the ipsilateral oculomotor nerve. As seen on brain MRI, thickening and enhancement of the oculomotor cranial nerve can be observed in these cases. We experienced a case of RPON in an adult patient who showed thickening and enhancement of the oculomotor nerve on gadolinium-enhanced 3D-FLAIR image. The authors report a case of RPON with a review of the literature.

• The Korean Journal of Pain
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• v.19 no.1
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• pp.104-106
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• 2006

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.

• The Journal of Korean Medicine
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• v.29 no.3
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• pp.155-160
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• 2008

Tolosa-Hunt syndrome (THS) is characterized by painful ophthalmoplegia and diagnosed by the exclusion of other major diseases. This study was done to find the effectiveness of electroacupuncture at oculomotor muscles and herbal-med on a THS patient. We used this method and Bogan-san ($B\check{a}og\check{a}n-s\check{a}n$) without steroids and treated a THS patient who suffered from pain behind the right eye, ophthalmoplegia, ptosis, frontal headache and dysosmia. 18 days after admission, the symptoms were improved and almost gone. In conclusion, we suggest electroacupuncture at oculomotor muscles and Bogan-san ($B\check{a}og\check{a}n-s\check{a}n$) is effective to treat THS without steroids, and we recommend more studies of this method on THS.

• Journal of Yeungnam Medical Science
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• v.40 no.2
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• pp.198-201
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• 2023

Invasive sphenoid sinus aspergillosis can mimic Tolosa-Hunt syndrome (THS), leading to frequent misdiagnoses and potentially fatal consequences. We report a case of invasive sphenoid sinus aspergillosis initially misdiagnosed as THS. A 79-year-old man presented with right periorbital pain, ophthalmoplegia, and loss of vision. Initial evaluations including magnetic resonance imaging (MRI), were normal. He was first diagnosed with THS based on clinical features. The disease progressed despite high-dose intravenous steroid treatment, and an enhancing mass-like lesion was found in the right orbital apex, cavernous sinus, and sphenoid sinus on follow-up MRI. Aspergillosis was eventually confirmed by sphenoid sinus biopsy. The patient developed cerebral infarction and finally died despite being treated with amphotericin B. Given that invasive sphenoid sinus aspergillosis may initially resemble THS, high suspicion and rapid histological examination are important for diagnosis.

• The Journal of Internal Korean Medicine
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• v.30 no.2
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• pp.431-437
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• 2009

Tolosa-Hunt syndrome is an idiopathic syndrome characterized by the formation of granulation tissue in the anterior cavernous sinus or superior orbital fissure, producing a painful ophthalmoplegia. We experienced a 66-year-old woman whose conditions improved through oriental medical treatment. We treated the patient with herbal medicine Liqiqufeng-san (理氣祛風散) and electro-acupuncture at Cuanzhu (瓚竹, BL2) and Yuyao (魚腰, Extra) acupuncture points with 1${\sim}$50Hz for 15min. After treatment, the patient's symptoms improved considerably. This result suggests that oriental medical treatment has good effect on Tolosa-Hunt syndrome.

• Clinical and Experimental Pediatrics
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• v.49 no.6
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• pp.696-699
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• 2006

Tolosa-Hunt syndrome is a rare disease in children characterized by dull, persistent pain around the affected eye and ophthalmoplegia caused by granulomatous inflammation in the cavernous sinus, superior orbital fissure, or orbit. Although spontaneous remission can occur, corticosteroids frequently have a dramatic response; however, recurrence can transpire after complete remission. We report an 11-year-old girl with Tolosa-Hunt syndrome who responded to corticosteroid promptly, without complications, but suffered three recurrences of headache and retro-orbital pain and required maintenance on a low dose of steroid.

• The Journal of the Society of Stroke on Korean Medicine
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• v.16 no.1
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• pp.81-88
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• 2015

■ Objectives The purpose of this clinical study is to evaluate the effect of Traditional Korean Medicine(KM) on a patient with Tolosa-Hunt syndrome. ■ Methods We treated a 58 years old male patien t with Tolosa-Hunt syndrome who had several clinical symptoms such as ocular pain, limitaion of ocular movement and unilateral ptosis. We used herbal medication, acupuncture, electro-acupuncture(EA), cupping, moxibustion, bee-venom injection. Then we evaluated the improvement by Numerical Rating scale(NRS), Distance of eye opening and ratio of pupil movement. ■ Results We demonstrated the decrease of pain score and improvement of equal ocular movement(EOM) and ptosis after the KM treatment. ■ Conclusion This study proved the effect of KM treatment on Tolosa-Hunt syndrome. It could cooperative treatment would be more effective than mono treatment of western medicine.