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Superior orbital fissure syndrome

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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Tolosa-Hunt Syndrome is a painful unilateral ophthalmoplegia caused by a granulomatous infiltration of nerves and muscles in the region of the superior orbital fissue. It is accompanied by partial or complete lesions of the third, fourth, fifth - ophthalmic division - and sixth cranial nerves. The ESR is usually raised.

Treatment with steroids e.g. prednisolone is usually effective.

Tolosa-Hunt syndrome should be distinguished from orbital granuloma, a mucocoele or carcinoma of the paranasal sinus, and the Miller-Fisher syndrome.


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