Tolosa Hunt syndrome?
Tolosa-Hunt syndrome is a painful ophthalmoplegia caused by idiopathic inflammation in the region of the superior orbital fissure.
Acute-onset deep retro-orbital pain often precedes the onset of diplopia.
MRI is a useful modality to confirm inflammation of the cavernous sinus, although sometimes it presents as normal.
While the pain will respond well to corticosteroids within 24 to 72 hours of therapy initiation, the ophthalmoparesis can take up to several months to resolve, and in severe cases may be permanent.
