Rodriguez-Homs Larissa G, Goerlitz-Jessen Mark, Das Samrat U
1 Duke University School of Medicine, Durham, NC, USA.
J Investig Med High Impact Case Rep. 2019 Jan-Dec;7:2324709619838309. doi: 10.1177/2324709619838309.
Tolosa-Hunt syndrome is characterized by a painful ophthalmoplegia secondary to a granulomatous inflammation in or adjacent to the cavernous sinus. Magnetic resonance imaging will show enhancement of the cavernous sinus and/or the orbital apex. Although this syndrome is extremely rare in children, it should be a diagnostic consideration in patients presenting with painful ophthalmoplegia with variable involvement of cranial nerves II to VI. The differential diagnosis for unilateral cavernous sinus lesion is broad, including vascular lesions (cavernous sinus thrombosis), inflammatory processes (sarcoidosis, autoimmune), neoplastic processes (schwannoma, lymphoma), as well as infectious etiologies. We describe a pediatric patient presenting with neurological symptoms from a unilateral cavernous sinus magnetic resonance imaging abnormality and the thorough diagnostic approach to arrive at the diagnosis of Tolosa-Hunt syndrome.
托洛萨-亨特综合征的特征是继发于海绵窦内或其附近肉芽肿性炎症的疼痛性眼肌麻痹。磁共振成像将显示海绵窦和/或眶尖强化。尽管该综合征在儿童中极为罕见，但对于出现疼痛性眼肌麻痹且伴有Ⅱ至Ⅵ脑神经不同程度受累的患者，应考虑这一诊断。单侧海绵窦病变的鉴别诊断范围广泛，包括血管病变（海绵窦血栓形成）、炎症性疾病（结节病、自身免疫性疾病）、肿瘤性疾病（神经鞘瘤、淋巴瘤）以及感染性病因。我们描述了一名因单侧海绵窦磁共振成像异常而出现神经症状的儿科患者，以及为明确托洛萨-亨特综合征诊断所采取的全面诊断方法。
