• The Korean Journal of Pain
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• v.2 no.2
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• pp.198-202
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• 1989

The Tolosa-Hunt syndrome is one of the rare disease with facial, especially peri-orbital pain, and ophthalomoplegia associated mostly with granulomatous lesions in cavernous sinus or superior orbital fissure. In addition to ophthalmoplegia by multiple cranial nerve involvement, the sympathetic nervous system may also be involved leading to Horner's syndrome. A typical Tolosa-Hunt syndrome has a neuro-radiologic finding of an increased density in the involved region, and a laboratory finding of an elevated ESR, as well as a dramatic response to systemic corticosteroid therapy. An unusual case of the Tolosa-Hunt syndrome with normal radiologic and laboratory findings, unresponsive to systemic corticosteroid, and some response of pain relief to a stellate ganglion block, is presented.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.16 no.1
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• pp.220-225
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• 2003

The Tolosa-Hunt syndrome is a symptom complex with unilateral painful ophthalmoplegia associated with retro-orbital pain, proptosis and Ⅲ, Ⅳ, Ⅴ-1, Ⅵ cranial nerves palsy due to nonspecific granulomatous inflammation in the superior orbital fissure or cavernous sinus. We experienced a 50 years old female patient with Tolosa-Hunt syndrome who had several clinical signs and symptoms such as ocular pain, headache, sensory loss of face, diplopia, and visual disturbance. In the point of Differentiation of Syndrome(辨證). this subject was diagnosed as Deficiency of yin in liver and kidney(肝腎陰虛), and was administrated with Yangyeummyungmoktang-Gamibang. After treatment of acupuncture and herbal medicine above symptoms were improved.

• The Journal of Internal Korean Medicine
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• v.30 no.2
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• pp.431-437
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• 2009

Tolosa-Hunt syndrome is an idiopathic syndrome characterized by the formation of granulation tissue in the anterior cavernous sinus or superior orbital fissure, producing a painful ophthalmoplegia. We experienced a 66-year-old woman whose conditions improved through oriental medical treatment. We treated the patient with herbal medicine Liqiqufeng-san (理氣祛風散) and electro-acupuncture at Cuanzhu (瓚竹, BL2) and Yuyao (魚腰, Extra) acupuncture points with 1${\sim}$50Hz for 15min. After treatment, the patient's symptoms improved considerably. This result suggests that oriental medical treatment has good effect on Tolosa-Hunt syndrome.

• Clinical and Experimental Pediatrics
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• v.49 no.6
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• pp.696-699
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• 2006

Tolosa-Hunt syndrome is a rare disease in children characterized by dull, persistent pain around the affected eye and ophthalmoplegia caused by granulomatous inflammation in the cavernous sinus, superior orbital fissure, or orbit. Although spontaneous remission can occur, corticosteroids frequently have a dramatic response; however, recurrence can transpire after complete remission. We report an 11-year-old girl with Tolosa-Hunt syndrome who responded to corticosteroid promptly, without complications, but suffered three recurrences of headache and retro-orbital pain and required maintenance on a low dose of steroid.

• The Journal of the Society of Stroke on Korean Medicine
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• v.16 no.1
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• pp.81-88
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• 2015

■ Objectives The purpose of this clinical study is to evaluate the effect of Traditional Korean Medicine(KM) on a patient with Tolosa-Hunt syndrome. ■ Methods We treated a 58 years old male patien t with Tolosa-Hunt syndrome who had several clinical symptoms such as ocular pain, limitaion of ocular movement and unilateral ptosis. We used herbal medication, acupuncture, electro-acupuncture(EA), cupping, moxibustion, bee-venom injection. Then we evaluated the improvement by Numerical Rating scale(NRS), Distance of eye opening and ratio of pupil movement. ■ Results We demonstrated the decrease of pain score and improvement of equal ocular movement(EOM) and ptosis after the KM treatment. ■ Conclusion This study proved the effect of KM treatment on Tolosa-Hunt syndrome. It could cooperative treatment would be more effective than mono treatment of western medicine.

• Journal of Acupuncture Research
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• v.18 no.5
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• pp.179-184
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• 2001

The Tolosa-Hunt syndrome(THS) 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. Generally, it has been reported that 2 weeks steroid therapy relieves the symptoms(periorbital pain, ophthalmoplegia) of THS. In this case, there had been no improvement of symptoms by western medical treatments(steroid & analgesics). but, the symptoms were resolved clearly by acupuncture therapy during 6 weeks(5 times/week). If more clinical trials like this are proved to be effective in THS, we can expect that acupuncture will be another therapeutical modality in THS.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.18 no.2
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• pp.86-92
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• 2005

Painful ophthalmoplegia due to idiopathic granulomatous inflammation of the cavernous sinus/superior orbital fissure has been termed Tolosa-Hunt syndrome(THS). The syndrome is characterized by pain behind, above or around the eye, involvement of the cranial nerves which pass through the cavernous sinus, spontaneous remissions and exacerbations, and a favourable response to steroid therapy. There was the 56 years old man who suffered from painful ophthalmoplegia and facial palsy. The oriental medical treatment without steroids and analgesics reduced the symptoms of the patient remarkably during 5 weeks. There is few report that treat THS with oriental medical method. If more clinical trials like this are proved to be effective, we can expect that oriental medical treatment will be a good method in THS.

• The Journal of Korean Medicine
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• v.29 no.3
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• pp.155-160
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• 2008

Tolosa-Hunt syndrome (THS) is characterized by painful ophthalmoplegia and diagnosed by the exclusion of other major diseases. This study was done to find the effectiveness of electroacupuncture at oculomotor muscles and herbal-med on a THS patient. We used this method and Bogan-san ($B\check{a}og\check{a}n-s\check{a}n$) without steroids and treated a THS patient who suffered from pain behind the right eye, ophthalmoplegia, ptosis, frontal headache and dysosmia. 18 days after admission, the symptoms were improved and almost gone. In conclusion, we suggest electroacupuncture at oculomotor muscles and Bogan-san ($B\check{a}og\check{a}n-s\check{a}n$) is effective to treat THS without steroids, and we recommend more studies of this method on THS.

• The Korean Journal of Pain
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• v.19 no.1
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• pp.104-106
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• 2006

Tolosa-Hunt syndrome is a rare self-limiting disease that's characterized by painful ophthalmoplegia. It has a relapsing and remitting course, and the pain responds promptly to systemic corticosteroid therapy. Yet it is diagnosed by the exclusion of other major causes involving the superior orbital fissure or cavernous sinus, including trauma, neoplasm, aneurysm and inflammation. Further, the associated ophthalmoplegia may follow days to weeks after the onset of orbital or hemifacial pain. Hence, this condition is often misdiagnosed as atypical facial pain, and so improper management could result in unnecessary suffering of the patient. The following case describes a patient suffering with hemifacial pain associated with ipsilateral abducens nerve palsy, which was evident 2 weeks after the onset of pain, and this was misdiagnosed as trigeminal neuralgia and atypical facial pain.

• Annals of Clinical Neurophysiology
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• v.18 no.1
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• pp.11-13
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• 2016

Idiopathic hypertrophic cranial pachymeningitis (ICHP) is diffuse inflammatory process of the dura mater. ICHP can produce similar presentation with Tolosa-Hunt syndrome (THS) if it involves cavernous sinus. A-29-year old male with persistent headache and no definite neurologic dysfunction was noted. Two weeks later, he complained of ophthalmoplegia, and his symptoms were thought to be manifestations of THS. Brain magnetic resonance images revealed diffuse thickened, enhanced pachymeninges in left tentorium. The patient was diagnosed with IHCP. We report a IHCP patient who showed very similar presentation as THS.