Abstract

BACKGROUND: Tolosa-Hunt syndrome is an idiopathic orbital or periorbital pain associated with paralysis of 3,4,6 cranial nerve secondary to non-specific inflammation of cavernous sinus or orbital apex. CASE PRESENTATION: A 61 years old female presented with pain and redness in BE with drooping of eyelid(Right>Left) since 5 days. On examination RE VA was FC2m with PR inaccurate in inferior quadrant,restricted movements in all gazes ,complete ptosis, pupillary reaction RAPD grade 2, fundus shows disc pallor. LE VA was 6/18 with PR accurate,restricted movements in all gazes,severe ptosis, pupil sluggishly reacting to light, fundus was WNL. MANAGEMENT: MRI orbit showed enlargement of the extraocular muscles. CONCLUSION: Tolosa-Hunt syndrome is rare disorder & diagnosis of exclusion and respond well to systemic steroids.