Cavernous sinus syndrome with painful ophthalmoplegia: aspects of differential diagnosis to consider

Introduction: Cavernous sinus syndrome with painful ophthalmoplegia is a rare disorder that affects 1-2 individuals per million annually and requires an assertive investigation, considering the multiple alternative diagnostic options that can impact the patient's clinical outcome. When the etiology is idiopathic, it is referred to as Tolosa-Hunt syndrome. Objective: The objective of this study is to report the case of a patient diagnosed with Tolosa-Hunt syndrome. Comment: Tolosa-Hunt syndrome clinically manifests with headache, severe eye pain accompanied by ophthalmoplegia and cranial oculomotor nerve palsy. The diagnosis is made through a combination of clinical assessment, laboratory analysis, imaging studies, and the exclusion of other potential etiologies. This case report discusses the investigation and clinical management of a previously healthy patient presenting with painful ophthalmoplegia, diagnosed as Tolosa-Hunt syndrome and treated with corticosteroids, who presented a favorable response to the treatment. (AU)