Year: 2025 | Month: January | Volume: 12 | Issue: 1 | Pages: 252-255
DOI: https://doi.org/10.52403/ijrr.20250132
Case Report on Tolosa Hunt Syndrome in a Diabetic Patient: An Uncommon Presentation
Ajay R1, Shubham B Harapanahalli1, Dr Veeranna Mohan Gadad2, Gunupati Balamani Chandana1, Gladys K Siji1
1Pharm D Interns, Department of Pharmacy Practice, Bapuji College of Pharmacy, Davanagere, Karnataka, India-577004,
2Associate Professor, Department of Neurology, SSIMS and RC, Davanagere, India-577004.
Corresponding Author: Shubham B Harapanahalli
ABSTRACT
Tolosa Hunt syndrome (THS), also known as painful ophthalmoplegia, recurrent ophthalmoplegia, or ophthalmoplegia syndrome, is described as severe and unilateral periorbital headaches associated with painful and restricted eye movements. THS is one of the rare disorders recognized by the National Organization for Rare Disorders. The estimated annual incidence is one case per million per year.
Case Report: A 49-year-old male with a 12-year history of Type 2 Diabetes Mellitus presented with diplopia, ptosis, and right-sided hemifacial pain. Neurological examination revealed right-sided levator palpebrae superioris palsy, complete ophthalmoplegia, and conjunctival hyperemia. MRI confirmed orbital apex syndrome (OAS) in the right orbit known as Tolosa hunt syndrome (THS), while paranasal sinus HRCT showed chronic sinusitis with significant mucosal thickening and structural abnormalities. Management included high-dose intravenous methylprednisolone with gastroprotective therapy, followed by a tapering course of oral prednisolone and gabapentin for neuropathic pain.
Keywords: Tolosa Hunt Syndrome (THS), Orbital Apex Syndrome (OAS), Methylprednisolone, Ophthalmoplegia
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