What is it?

A Tolosa-Hunt syndrome is an episodic pain of the orbit associated with paralysis of one or more of the third, fourth, and/or sixth cranial nerves. It usually resolves spontaneously, but can relapse.

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Signs & symptoms

Tolosa-Hunt syndrome is characterized by painful ophthalmoparesis (muscle paresis of the eye) or ophthalmoplegia (muscle pain of the eye). Patients may complain of double vision, headaches, dizziness, nausea, neck stiffness, photophobia, blurred vision, and a "boring" pain associated with the headache.


A MRI or MRA provides more detailed information about the cavernous sinus and orbital apex than a CT. An MRI may provide details about granulomatous inflammation, assisting in the diagnosis of Tolosa-Hunt syndrome. However, these results may not be reliable. Additionally, biopsy can be used to demonstrate granulomatous inflammation, but it may be more difficult.


The mainstay of treatment is oral steroids.

☝️ This is not a substitute for professional medical advice. Please consult with your physician before making any medical decision.

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