Attout H, Rahmeh F, Ziegler F
Service de neurologie, centre hospitalier, Belfort, France.
Rev Med Interne. 2000 Sep;21(9):795-8. doi: 10.1016/s0248-8663(00)00226-5.
Tolosa-Hunt syndrome is characterized by painful ophthalmoplegia due to idiopathic granulomatous inflammation of the cavernous sinus. Steroid therapy dramatically reverses the symptoms and clinical signs. Because they also may respond to steroids, tumors such as lymphoma and meningioma and orbital tumors can make differential diagnosis difficult.
We report the case of a 78-year-old male patient in whom systemic lymphoma associated with inflammation of the cavernous sinus was uncovered by painful, gradually progressing, ophthalmoplegia mimicking Tolosa-Hunt syndrome.
When faced with a clinical picture suggestive of the existence of Tolosa-Hunt syndrome clinical workup is mandatory and should lead to diagnosis of exclusion.
托洛萨-亨特综合征的特征是由于海绵窦特发性肉芽肿性炎症导致的疼痛性眼肌麻痹。类固醇疗法可显著逆转症状和体征。由于淋巴瘤、脑膜瘤等肿瘤以及眼眶肿瘤对类固醇也可能有反应，因此鉴别诊断较为困难。
我们报告一例78岁男性患者，其表现为类似托洛萨-亨特综合征的疼痛性、逐渐进展的眼肌麻痹，经检查发现为系统性淋巴瘤合并海绵窦炎症。
当面对提示存在托洛萨-亨特综合征的临床表现时，必须进行临床检查，并应通过排除法做出诊断。
