Tessitore E, Tessitore A
Operative Unit of Neurotraumatology, Department of Neurosurgery, Second University of Naples, Italy.
Headache. 2000 May;40(5):393-6. doi: 10.1046/j.1526-4610.2000.00060.x.
The Tolosa-Hunt syndrome consists of a painful ophthalmoplegia related to a granulomatous inflammatory process in the cavernous sinus, which may be documented by cerebral magnetic resonance imaging with gadolinium enhancement. Two cases of Tolosa-Hunt syndrome preceded by facial palsy observed in 1998 at the Department of Neurosurgery of the Second University of Naples are presented here. Both patients developed Tolosa-Hunt syndrome following an ipsilateral facial palsy that resolved in about 15 days with medical treatment. Cerebral magnetic resonance imaging with gadolinium enhancement showed, in both cases, inflammatory tissue in the cavernous sinus. The patients underwent corticosteroid therapy (prednisolone, 80 mg per day, intravenously) with pain regression. In the first case, the patient experienced recurrence of the syndrome that was definitively resolved with further corticosteroid treatment. The rare reports of facial palsy in patients with Tolosa-Hunt syndrome suggest the inclusion of this disease in the so-called multiple cranial nerve palsy syndrome. It is probable that Tolosa-Hunt syndrome has an inflammatory pathogenesis.
托洛萨-亨特综合征表现为与海绵窦肉芽肿性炎症过程相关的疼痛性眼肌麻痹，这可通过钆增强脑磁共振成像得以证实。本文报告了1998年在那不勒斯第二大学神经外科观察到的2例先有面瘫的托洛萨-亨特综合征病例。两名患者均在同侧面瘫后出现托洛萨-亨特综合征，经药物治疗约15天后面瘫缓解。钆增强脑磁共振成像在两例中均显示海绵窦有炎症组织。患者接受了皮质类固醇治疗（泼尼松龙，每天80毫克，静脉注射），疼痛消退。在第一例中，患者综合征复发，经进一步皮质类固醇治疗最终得以解决。托洛萨-亨特综合征患者中罕见的面瘫报告提示应将该病纳入所谓的多颅神经麻痹综合征。托洛萨-亨特综合征很可能具有炎症性发病机制。
