Yamamoto Daisuke, Tsuda Emiko, Saitoh Masaki, Imai Tomihiro, Shimohama Shun
Department of Neurology, Sapporo Medical University School of Medicine.
Rinsho Shinkeigaku. 2014;54(11):903-6. doi: 10.5692/clinicalneurol.54.903.
A 30-year-old woman was admitted to our hospital because of intractable orbital pain and ptosis on the left side. On admission, she had left oculomotor, ophthalmic and maxillary nerves palsy. MRI revealed a contrast enhanced lesion of the left oculomotor and trigeminal nerves through the covernous sinus and orbita. We diagnosed her condition as Tolosa-Hunt syndrome. The orbital pain was resolved within 48-hours by the pulse therapy with intra-venous methylpredonisolone. The cranial nerve palsy was gradually improved, but never reached complete remission. The left oculomotor and trigeminal nerves also remained enhanced on MRI until 200 days from the onset. Although there have been few reports to demonstrate the contrast enhancement of cranial nerves in Tolosa-Hunt syndrome, these MRI findings may be a specific indicator of the pathological process.
一名30岁女性因左侧眼眶顽固性疼痛和上睑下垂入住我院。入院时，她存在左侧动眼神经、眼神经和上颌神经麻痹。磁共振成像（MRI）显示左侧动眼神经和三叉神经通过海绵窦和眼眶有强化病灶。我们将她的病情诊断为托洛萨-亨特综合征。通过静脉注射甲泼尼龙进行脉冲治疗，眼眶疼痛在48小时内得到缓解。颅神经麻痹逐渐改善，但未完全缓解。直至发病200天时，MRI显示左侧动眼神经和三叉神经仍有强化。尽管很少有报道表明托洛萨-亨特综合征中颅神经有强化表现，但这些MRI表现可能是病理过程的一个特异性指标。
