[Painful Tolosa-Hunt ophthalmoplegia. Apropos of a case in a child].

Painful ophthalmoplegia occurred in a twelve-year-old boy, with repeated attacks over five years. This fits the description of Tolosa-Hunt syndrome which has only infrequently been described in children. Tolosa-Hunt syndrome combines severe lasting orbital pain and paralysis of one or more oculomotor nerves (extrinsic or intrinsic III, IV, VI). Pain is dramatically alleviated by high doses of corticosteroids, while the ophthalmoplegia improves more slowly. For some authors, this effect of corticosteroids is diagnostic. Repeated attacks occur over several years and resolve spontaneously with or without sequellae. Diagnosis can only be ascertained after careful ruling out of a general or locoregional etiology through clinical and paraclinical investigations. Differential diagnosis with ophthalmoplegic migraine may be difficult.