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Tolosa Hunt Syndrome (THS)

Tolosa Hunt Syndrome (THS)

November 4, 2021 Conditions of Eyes and Vision No Comments

What is THS?

THS is a rare severe painful condition of an eye resulting from an inflammatory process behind the eye. It is also called painful ophthalmoplegia.

What is the cause of THS?

It is caused by an inflammatory process called granuloma. Exact cause of this inflammation is not known. Location of inflammation is in the cavernous sinus (an area behind the eye) and superior orbital fissure (a bony opening behind the eye-globe). Rarely, there could be an alternate cause such as an aneurysm, tumor or trauma. Many cranial nerves pass through the cavernous sinus, which if involved may cause weakness of eye muscles, numbness or facial weakness.

 

What are symptoms of THS?

  • One-sided pain in and around the eye
  • Difficulty moving the eye without pain
  • Facial numbness or weakness

 

What are signs of THS?

  • Weakness of eye muscles
  • Ptosis or droopiness of eyelid
  • Pupillary abnormalities
  • Facial weakness or numbness if the condition has extended to other cranial nerves

 

How is THS diagnosed?

It is diagnosed based upon its symptoms and clinical findings. MRI with and without contrast can be especially helpful to diagnosed and localize the inflammatory process.

 

How is THS treated?

High dose steroid or prednisone is the treatment of choice. Starting with higher dose (60-80mg daily), prednisone is tapered off in a few weeks.

 

Where can I get more information on THS?

American Academy of Neurology

American Ophthalmological Society

American Headache Society

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