소아에서 발생한 Tolosa-Hunt 증후군 1례

Tolosa-Hunt Syndrome in a Child

Tolosa-Hunt 증후군은 안구 통증과 안구 운동 마비를 특징적으로 나타내는 드문 질환으로 해면정맥동(cavernous sinus)에 육아종성 염증 소견을 보이는 질환이다. 저자들은 안구 통증과 두통, 안구 운동 마비를 주소로 내원한 12세 여자 환자에서 뇌 자기공명영상 검사를 통해 Tolosa-Hunt 증후군 진단 후 스테로이드 치료로 호전된 증례를 경험 하였기에 문헌 고찰과 함께 보고하는 바이다.

Tolosa-Hunt syndrome is a rare disease caused by non-specific inflammation of the cavernous sinus, superior orbital fissure and the apex of the orbit. It is characterized by ophthalmoplegia, unilateral headache or periorbital pain. Brain magnetic resonance imaging (MRI) usually shows an inflammation of cavernous sinus. It is known that steroid pulse therapy is effective. In this case, we diagnosed a 12-year-old female with Tolosa-Hunt syndrome suffered from left ophthalmoplegia and left sided headache. Her Brain MRI showed mild enlargement of left cavernous sinus. After methylprednisolone pulse therapy and following dexamethasone treatment, her symptoms were markedly improved. In children who suffer from periorbiral pain and ophthalmoplegia, proper brain MRI could be helpful in differential diagnosis including Tolosa-Hunt syndrome.