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CASE REPORT
Year : 2021  |  Volume : 1  |  Issue : 4  |  Page : 785-787

Recurrent alternating Tolosa-Hunt syndrome mimicking idiopathic hypertrophic pachymeningitis


Mahatma Gandhi Medical College and Research Institute, Pondicherry, India

Correspondence Address:
Dr. Muthukrishnan Vallinayagam
Mahatma Gandhi Medical College and Research Institute, Pillayarkuppam, Pondicherry - 607 402
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijo.IJO_3309_20

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Tolosa–Hunt syndrome (THS) is a granulomatous inflammation in cavernous sinus or orbital apex. Recurrences are encountered ipsilaterally. Contralateral involvement is known as alternating THS. A middle-aged man presented with right sided headache and vomiting. Magnetic resonance imaging (MRI) revealed hyperintense lesion in right orbital apex with inflammatory changes in superior orbital fissure. A diagnosis of idiopathic hypertrophic pachymeningitis (IHP) was entertained. Within 48 h, there was complete ptosis and markedly restricted ocular movements. MRI done 3 months prior revealed similar features in left eye. A rare case of recurrent alternating THS with radiological evidence is portrayed here.


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