Tolosa-Hunt syndrome (THS) is a rare disorder indicated by recurrent painful ophthalmoplegia caused by non-specific inflammation of the cavernous sinus or superior orbital fissure (SOF). The disease shares histopathological features with idiopathic orbital pseudotumour; however, owing to its anatomical location, it produces characteristic clinical manifestations.1 Recurrent retro-orbital pain, with palsies of the third, fourth or sixth cranial nerves as well as the first and second divisions of the trigeminal nerve, are typical. Clinically, immediate response to steroid therapy is a hallmark of the condition. The clinical presentation of THS has a wide differential diagnosis, and timely and appropriate imaging – as an adjunct to pertinent laboratory investigations – can greatly assist clinicians with early accurate diagnosis and management.

Tolosa-Hunt Syndrome