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MRI in Tolosa-Hunt Syndrome Associated With Facial Nerve Palsy


  • Heeyoung Kang MD,

  • Ki-Jong Park MD,

  • Seungnam Son MD,

  • Dae Seob Choi MD,

  • Jae Wook Ryoo MD, PhD,

  • Oh-Young Kwon MD, PhD,

  • Nack-Cheon Choi MD, PhD,

  • Byeong Hoon Lim MD, PhD

  • From the Departments of Neurology (Drs. Kang, Park, Son, Kwon, Choi, and Lim); and Radiology, (Drs. Choi and Ryoo), Gyeongsang Institute of Health Sciences, Gyeongsang National University College of Medicine, Jinju, Korea.

Address all correspondence to Dr. Ki-Jong Park, Gyeongsang Institute of Health Sciences, Department of Neurology, Gyeongsang National University College of Medicine, 90 Chiram-dong, Jinju 660-702, Korea.


A 44-year-old woman developed a severe right frontotemporal headache, retro-orbital pain, and, later, diplopia owing to right sixth nerve palsy. The brain MRI demonstrated strong enhancement of the right cavernous sinus. The sixth nerve palsy and headache improved with steroid therapy after 6 weeks. At that time, she suffered right peripheral facial nerve palsy. Enhancement of the distal canalicular and labyrinthic segment of the right facial nerve was found on contrast-enhanced MRI. To our knowledge, this is a very rare case of Tolosa-Hunt syndrome with facial nerve palsy, with simultaneous enhancement of the cavernous sinus and facial nerve on contrast-enhanced MRI.

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