Tolosa-Hunt Syndrome-MRI

• Tolosa-Hunt syndrome (THS) is a painful ophthalmoplegia caused by nonspecific inflammation of the cavernous sinus or superior orbital fissure.
• Nonspecific inflammation within the cavernous sinus or superior orbital fissure is the cause of the constant pain, which characterizes the onset of this disorder.
• Inflammatory changes in the cavernous sinus, superior orbital fissure, and/or orbital apex are typically observed on high-resolution contrast-enhanced imaging. These changes are not specific for Tolosa-Hunt syndrome and may also be present in neoplastic conditions of the cavernous sinus.  Narrowing of the internal carotid artery within the cavernous sinus may be identified.

This patient had double vision and headache, with VI nerve palsy on examination and showed significant relief after corticosteroids.