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首页> 外文期刊>Journal of Clinical Medicine Research >Tolosa-Hunt Syndrome: A Non-Classical Presentation of a Rare Cause of Unilateral Headache and Painful Ophthalmoplegia
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Tolosa-Hunt Syndrome: A Non-Classical Presentation of a Rare Cause of Unilateral Headache and Painful Ophthalmoplegia

机译：Tolosa-Hunt综合征：非古典呈现单侧头痛和疼痛的眼科剧集的罕见原因

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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. It is a diagnosis of exclusion after ruling out other causes of painful ophthalmoplegia and is treated with high-dose steroids. We present a case of a 43-year-old woman with a history of recurrent headaches and vision disturbances for the past 4 years presenting with worsening left-eye pain that radiated to the back of her head, swelling around the left eye, double vision, and a unilateral left-sided headache. Visual acuity was decreased in the left eye compared to the right and the patient reported left-eye pain when at extreme medial and lateral gaze. Erythrocyte sedimentation rate (ESR) was found to be elevated with all other laboratory testing within normal limits. Computed tomography (CT) scan of the orbits was unremarkable. Ophthalmology excluded other differential diagnoses and she was treated with intravenous methylprednisolone with significant improvement of symptoms. The triad of one or more episodes of unilateral orbital pain, paresis of one or more of the cranial nerves, and granulomas by magnetic resonance imaging (MRI) or biopsy is 95-100% sensitive at diagnosing the syndrome; however, our patient did not present with the "classic" triad. Initial treatment of Tolosa-Hunt is with high-dose steroids which as in our case lead to rapid and significant improvement of symptoms.Copyright 2020, Douedi et al.
机译：甲状腺肿综合征是一种难以涉及轨道和复古轨道空间的罕见条件。典型的症状是轨道疼痛，肿胀，头痛，颅神经的麻痹，以及三叉神经分布的感觉损失。 Tolosa-Hunt综合征复活并汇集了分隔数月到几年的集中。判断出疼痛的眼科动脉粥样杆菌的其他原因并用高剂量类固醇治疗后，这是一种诊断。我们提出了一个43岁女性的案例，过去4年患者呈现出反复出现的头痛和视力紊乱，呈现出左眼疼痛的左眼疼痛，左眼肿胀，双重视野，单侧左侧头痛。与右眼相比，左眼和患者在极端内侧和横向凝视时报告左眼疼痛的视力减少。发现红细胞沉降率（ESR）在正常限制内随着所有其他实验室测试升高。轨道的计算机断层扫描（CT）扫描不起眼。眼科排除了其他差异诊断，并用静脉注射甲基己酮治疗，具有显着改善的症状。单侧眶疼痛的一个或多个发作的三合会，一种或多种颅神经的颅骨，磁共振成像（MRI）或活组织检查的颗粒组织在诊断综合征处敏感95-100％;但是，我们的患者没有出现“经典”三合会。靶向甲状腺素的初始治疗具有高剂量类固醇，这与我们的案例导致症状的快速和显着改善。柔眩器2020，Douedi等。

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