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  5. FP0609 : Tolosa Hunt syndrome Mimicking Retrobulbar Neuritis

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Chief & Presenting Author: Dr.NIHARIKA

Co Author(s): Prof.Raman Yenugandula

Abstract

Study design- Case report
Purpose- To report a case of Tolosa hunt syndrome mimicking Retrobulbar neuritis
Methods- 41 yrold male presented with sudden onset severe unilateral headache with sudden progressive loss of vision in left eye since 15 days .associated with painful eye movements .on examination- BCVA RE – 6/12 ,LE -CF1/2 mtr.
RE- Insignificant
LE – RAPD GR 1 ,Fundus – normal.EOM- painful ,full & free.
All cranial nerves intact except left optic nerve.
Investigation- MRI Brain & Orbit with contrast enhancement.- s/o Tolosa hunt syndrome /sarcoidosis with orbital apex and superior orbital fissure involvement .sarcoidosis ruled out.Inj IV Methylprednisolone 1 gm 5 doses given .
Result-In this case Inflammation in orbital apex instead of Cavernous sinus resulted in atypical presentation mimicking Retrobulbar neuritis.
Conclusion- Tolosa hunt syndrome is rare idiopathic disease .Neuroimaging plays an important role in diagnosis of diseases presenting with atypical symptoms