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Prim Care Companion CNS Disord 2021 Jun 10;23(3). Epub 2021 Jun 10.

Dayanand Medical College and Hospital, Tagore Nagar, Civil Lines, Ludhiana, Punjab, India.

BMC Ophthalmol 2021 May 27;21(1):237. Epub 2021 May 27.

Department of Ophthalmology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, 158, Paryong-ro, Masanhoewon-gu, 51353, Changwon, Korea.

Background: The objective of this study was to investigate the clinical features and outcomes of Tolosa-Hunt syndrome (THS).

Methods: A retrospective review of the medical records was performed on patients with THS between March 2016 and January 2020. A total of eleven patients fulfilling the International Classification of Headache Disorders (ICHD-3 beta) diagnostic criteria for THS were included in this study. Read More

Int J Ophthalmol 2021 18;14(4):633-635. Epub 2021 Apr 18.

University Malaya Eye Research Centre, Department of Ophthalmology, University of Malaya, Kuala Lumpur 50603, Malaysia.

Ann Vasc Surg 2021 Apr 7. Epub 2021 Apr 7.

Department of Vascular Surgery, 2nd Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China. Electronic address:

Multiple spontaneous visceral arterial dissections are an infrequent occurrence. The etiology, risk factors and natural history of these dissections have not been elucidated, and the optimal therapeutic strategy has not been established. We report a rare case of multiple spontaneous visceral arterial dissections involving the celiac artery, splenic artery, superior mesenteric artery, and right renal artery in a patient with Tolosa-Hunt syndrome on short-term corticosteroid therapy. Read More

Acta Neurol Belg 2021 Apr 7. Epub 2021 Apr 7.

Department of Neurology, Ege University, 35000, Bornova, Izmir, Turkey.

J Craniofac Surg 2021 Jan 28. Epub 2021 Jan 28.

Department of Otorhinolaryngology-Head and Neck Surgery, Konyang University College of Medicine Department of Neurology, Konyang University College of Medicine, Daejeon, Republic of Korea.

Abstract: Tolosa-Hunt syndrome (THS) is a rare benign disease caused by granulomatous inflammation in the craniofacial region. It is mostly idiopathic and generally presents with painful ophthalmoplegia, ipsilateral oculomotor paresis, and steroid responsiveness. There are few reports of THS after sinus surgery. Read More

Endocr Pract 2020 Oct;26(10):1231

From the Division of Endocrinology, UCLA David Geffen School of Medicine, Los Angeles, California.. Electronic address:

BMJ Case Rep 2021 Jan 18;14(1). Epub 2021 Jan 18.

Department of Neurosciences, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila, Metro Manila, Philippines.

Tolosa-Hunt syndrome (THS) is a rare syndrome of painful ophthalmoplegia secondary to an idiopathic granulomatous inflammation affecting the cavernous sinus, superior orbital fissure or orbit. Pregnancy and pregnancy-related hormones have been identified as potential triggers. A 39-year-old gravida-2 para-1 woman with prior chronic intake of combined oral contraceptives (COC) suffered two episodes of painful ophthalmoplegia-the first event with spontaneous remission and the relapse occurring during pregnancy and with complete resolution following steroid treatment. Read More

Arch Soc Esp Oftalmol (Engl Ed) 2020 Dec 28. Epub 2020 Dec 28.

Servicio de Neurología Clínica, Universidad Nacional de Colombia, Bogotá, Colombia; Grupo de investigación en Neurología de la Universidad Nacional de Colombia, NEUROUNAL, Bogotá, Colombia.

Painful ophthalmoplejía syndrome is characterised by the presence of peri-orbital or peri-cranial pain that is accompanied by paralysis of the oculomotor nerves. The differential diagnosis is broad, and requires a rigorous study. Three clinical cases of patients with painful ophthalmoplejía syndrome are described, in which multiple extension studies were required to obtain an aetiological diagnosis. Read More

J Oral Facial Pain Headache 2020 Fall;34(4):374-378

Recurrent painful ophthalmoplegic neuropathy (RPON) is a very rare disease characterized by recurrent attacks (at least two) of unilateral headache associated with ipsilateral ophthalmoplegia due to paresis of one or more cranial motor nerves, not due to any orbital, parasellar, or posterior fossa lesions. The differential diagnoses for this condition are broad. In addition to disability during an acute attack, this disease could also cause a permanent neurologic deficit. Read More

Neuroradiol J 2020 Dec;33(6):501-507

Department of Neurology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

Background And Purpose: The cavernous sinus is a unique region owing to anatomical factors and the pathologies affecting it. The diagnosis of cavernous sinus syndrome (CSS) predominantly relies on clinicoradiological correlation. We studied the utility of computed tomographic (CT) scan versus magnetic resonance imaging (MRI) in the diagnosis of CSS. Read More

Case Rep Neurol Med 2020 7;2020:8883983. Epub 2020 Nov 7.

Université Cheikh Anta Diop, Dakar, Senegal.

Tolosa-Hunt syndrome is a painful ophthalmoplegia characterized by recurrent unilateral orbital pain, ipsilateral oculomotor paralysis, and a rapid response to steroids. Our report describes a 37-year-old young woman who presented with right ptosis, ipsilateral ophthalmoplegia, and painful headache with no other neurological deficits in which all biological and neuroimaging investigations were normal. Complete recovery within one week of corticosteroid therapy was observed. Read More

Surv Ophthalmol 2020 Oct 28. Epub 2020 Oct 28.

Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.

A 69-year-old woman presented with chronic, painful, progressive binocular diplopia. Examination showed deficits in multiple sequential cranial nerves (II, III, IV, V, and VI). She was initially diagnosed with Tolosa-Hunt syndrome and had a partial response to systemic corticosteroids. Read More

Vestn Oftalmol 2020 ;136(6):84-92

Research Institute of Eye Diseases, Moscow, Russia.

The article reviews the main ocular features of Herpes Zoster Ophthalmicus (HZO) including Ramsay-Hunt and Tolosa-Hunt syndromes that involve III, IV and VI pairs of cranial nerves and I branch of the trigeminal nerve, and describes treatment methods of its active manifestations and postherpetic neuralgia, as well as herpes zoster vaccination practices. Read More

J Clin Neurol 2020 Oct;16(4):674-680

Dizziness Center, Clinical Neuroscience Center, Department of Neurology, Seoul National University Bundang Hospital, Seongnam, Korea.

Background And Purpose: Orbital and cranial form of idiopathic inflammatory pseudotumors (IIPs) are rare disorders with heterogeneous clinical presentations. Corticosteroids have been the first-line treatment for IIPs, but they are not always effective.

Methods: We reviewed the medical records of three patients with orbital or cranial form of IIP who were treated with tacrolimus as an adjuvant treatment. Read More

Eur J Rheumatol 2021 Jan 8;8(1):51-52. Epub 2020 Sep 8.

Department of Ophthalmology, Guru Nanak Eye Centre, Maulana Azad Medical College, Maharaja Ranjit Singh Marg, Delhi, India.

Neuropediatrics 2021 02 6;52(1):1-5. Epub 2020 Sep 6.

Department of Neurology, Federal University of Delta of Parnaíba, Fátima, Parnaíba, Brazil.

Objectives: The aim of the study is to review the articles published in the last 10 years on Tolosa-Hunt syndrome (THS) in childhood and adolescence to learn about its clinical and epidemiological characteristics and its therapeutic management.

Methods: Based on the literature search in the major medical databases and using the descriptors "Tolosa-Hunt syndrome and children" and "Tolosa-Hunt syndrome and adolescent" we included articles published between 2009 and 2019. We found 51 articles, but only 11 met the inclusion criteria. Read More

J AAPOS 2020 10 2;24(5):316-319. Epub 2020 Sep 2.

Department of Ophthalmology, Children's National Hospital, Washington, DC.

Tolosa-Hunt syndrome is a rare disorder characterized by granulomatous inflammation involving the cavernous sinus, superior orbital fissure, and/or orbit with no additional underlying cause. Tolosa-Hunt syndrome most often presents with painful ophthalmoplegia involving one or multiple cranial nerves. Here we report the case of an 8-year-old girl who presented, atypically, without the hallmark finding of pain. Read More

Agri 2020 Aug;32(3):171-174

Department of Radiology, Radiological Diagnostic Center, Bursa, Turkey.

Tolosa-Hunt Syndrome (THS) is an idiopathic condition characterized by periorbital and hemicranial pain, ipsilateral oculomotor and sixth cranial nerve involvement, good response to steroids, granulomatous inflammation of the cavernous sinus or the top of the orbita. A 25 year- old- male patient presented with severe burning burn pain near the left eye with double vision. The left eye exhibited semiptosis, limited outward gaze, and difficulty in the downward outward gaze. Read More

J Integr Neurosci 2020 Jun;19(2):355-357

Department of Neurology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning Province, 116000, P. R. China.

Tolosa-Hunt syndrome is an uncommon disease that exhibits unilateral periorbital pain or headache, accompanied by cranial nerve palsies. Myasthenia gravis is an acquired immune system disease involving the neuromuscular junction. One rare case of Tolosa-Hunt syndrome combined with ocular myasthenia gravis had been reported in the literature, but not general myasthenia gravis. Read More

Neuroradiol J 2020 Oct 10;33(5):424-427. Epub 2020 Jul 10.

Department of Radiology, Mayo Clinic, USA.

Tolosa-Hunt syndrome is characterized by unilateral retro-orbital headaches and cranial nerve palsies, usually involving cranial nerves III-VI. It is rare for other cranial nerves to be involved, although this has previously been reported. We report a 19-year-old woman presenting with typical features of Tolosa-Hunt syndrome but ultimately developing bilateral facial nerve palsies and enhancement of both facial nerves on magnetic resonance imaging. Read More

Arch Rheumatol 2020 Mar 25;35(1):128-131. Epub 2019 Jun 25.

Department of Internal Medicine, Wonkwang University Hospital, Iksan, South Korea.

Behçet's disease (BD) is a rare, chronic, auto-inflammatory disorder of unknown origin. Mucocutaneous lesions and pan-uveitis constitute the hallmark of BD. Additionally, vessels of all sizes and types are affected. Read More

Clin Imaging 2020 Dec 18;68:71-89. Epub 2020 Jun 18.

NYU Langone Health, Department of Radiology, New York, NY, United States of America. Electronic address:

The cavernous sinus is a complex structure susceptible to a wide variety of vascular, neoplastic and inflammatory pathologies. Vascular pathologies include ICA aneurysms, carotid-cavernous fistulas, cavernous sinus thrombosis, and cavernous hemangioma. Neoplasms that involve the cavernous sinus include pituitary adenoma, meningioma, schwannoma, lymphoma, perineural tumor spread, metastases, and direct tumor invasion. Read More

Neurol Sci 2020 11 5;41(11):3357-3360. Epub 2020 Jun 5.

Department of Neurology, Chonnam National University Hospital and Chonnam National University Medical School, 42 Jebong-ro, Dong-gu, Gwangju, 61469, South Korea.

Indian J Ophthalmol 2020 06;68(6):1212-1214

Dr. Rajendra Prasad Centre for Ophthalmic Sciences, New Delhi, India.

Optic perineuritis is an inflammatory disorder involving the optic nerve sheath. It is currently considered as a part of idiopathic orbital inflammatory disease which also includes dacryoadenitis, orbital myositis, superior orbital fissure, and cavernous sinus syndrome (Tolosa hunt syndrome). As it is idiopathic, it is considered a diagnosis of exclusion. Read More

J Clin Med Res 2020 Apr 30;12(4):266-268. Epub 2020 Mar 30.

Department of Medicine, Jersey Shore University Medical Center, Hackensack Meridian Health, Neptune, NJ 07753, USA.

Tolosa-Hunt syndrome is a rare condition involving the orbital and retro-orbital space. The typical symptoms are orbital pain, swelling, headache, palsies of the cranial nerves, and sensory loss in the distribution of the trigeminal nerve. Tolosa-Hunt syndrome relapses and remits with episodes separated by months to years. Read More

Medicine (Baltimore) 2020 Apr;99(17):e19882

Department of Neurology.

Rationale: Tolosa-Hunt syndrome (THS) is rare condition characterized by painful ophthalmoplegia that usually responds well to corticosteroid. About a half of THS patients experience recurrence within intervals of months to years from initial presentation. Recurrence is more common in younger patients, and can be ipsilateral, contralateral, or bilateral. Read More

Case Rep Neurol Med 2020 30;2020:6737018. Epub 2020 Mar 30.

Department of Neurology, Toyohashi Municipal Hospital, Toyohashi, Japan.

Objective: Painful ophthalmoplegia includes nonspecific magnetic resonance imaging (MRI) manifestations and various clinical features including orbital pain and cranial nerve palsies. Treatment for painful ophthalmoplegia remains controversial. The aim of this report was to describe detailed clinical features, MRI findings, treatments, and prognosis of patients with painful ophthalmoplegia. Read More

Can J Ophthalmol 2020 08 31;55(4):e135-e139. Epub 2020 Mar 31.

University of Toronto, Toronto, Ont.. Electronic address:

Ann Indian Acad Neurol 2020 Mar-Apr;23(2):201-205. Epub 2020 Feb 25.

Department of Neurological Sciences, Neurology Unit, Christian Medical College and Hospital, Vellore, Tamil Nadu, India.

Background: Tolosa-Hunt Syndrome (THS) is one of the causes of cavernous sinus syndrome causing painful ophthalmoplegia. Literature on long-term outcome of this rare condition is scarce.

Aims And Objectives: The aim is to study the recurrence and role of steroid-sparing agents in THS. Read More