A man with painful opthalmoplegia, cavernous sinus dilatation: diagnosis is
Correct Answer: Tolosa Hunt syndrome
Description: Tolosa-Hunt syndrome (THS) is a painful ophthalmoplegia caused by nonspecific inflammation of the cavernous sinus or superior orbital fissure. Cavernous sinus thrombosis symptoms include: decrease or loss of vision, chemosis, exophthalmos (bulging eyes), headaches, and paralysis of the cranial nerves which course through the cavernous sinus. Gradenigo's syndrome, is a complication of otitis media and mastoiditis involving the apex of the petrous temporal bone. Orbital pseudotumor is the most common painful orbital mass in the adult population, and is associated with proptosis, cranial nervepalsy (Tolosa-Hunt syndrome), uveitis, and retinal detachment. Ref Harrison20th edition pg 2456
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