TOLOSA-HUNT SYNDROME: A CASE REPORT

Autori:

Marijan Kovačić, Ivan Kovačić, Ana Krvavica, Ivica Nekić, Mladen Harapin

Sažetak

Sažetak. Tolosa-Huntov sindrom nespecifična je granulomatozna upala kavernoznog sinusa, gornje orbitalne fisure i orbitalnog vrha. Uključuje epizode jednostrane orbitalne boli koja može trajati nekoliko tjedana, lezije 3, 4. ili 6, a rijetko 2, 5, 7 i 8. kranijalnog živca. Karakteriziran je remisijama i egzacerbacijama te može izazvati trajne neurološke ispade zahvaćenih živaca. Prikazan je tijek bolesti kod bolesnika čiji je inicijalni simptom bio postupni gubitak vida desnog oka te potom neuralgične boli u području desne orbite i lica. Dijagnoza je potvrđena biopsijom te je provedena kortikosteroidna terapija. Egzacerbacija bolesti zahtijevala je ponovni kirurški zahvat, eksciziju fibroznog tkiva kavernoznog sinusa, kao i prolongiranu kortikosteroidnu terapiju.

Summary

Summary. Tolosa-Hunt syndrome is a nonspecific granulomatous inflammation of the cavernous sinus, superior orbital fissure and apex of the orbit. It involves episodes of unilateral orbital pain which may last several weeks, lesions of cranial nerve III, IV or VI, and rarely II, V, VII and VIII. It is characterized by remissions and exacerbations, and can cause permanent neurological disorder of the affected nerves. We present the course of the disease in a patient whose initial symptom was gradual visual loss in the right eye, followed by neuralgic pain in the right orbit and face. The diagnosis was confirmed by biopsy and corticosteroid therapy was administered. Exacerbation of the disease required repeated surgery, excision of the fibrous tissue of the cavernous sinus, as well as prolonged corticosteroid therapy.