Painful ophthalmoplegia: Overview with a focus on Tolosa-Hunt syndrome

Jonathan P. Gladstone, David W. Dodick

Research output: Contribution to journalReview articlepeer-review

27 Scopus citations


Painful ophthalmoplegia is an important presenting complaint to emergency departments, ophthalmologists, and neurologists. The etiological differential diagnosis of painful ophthalmoplegia is extensive and consists of numerous sinister etiologies including vascular (eg, aneurysm, carotid dissection, carotid-cavernous fistula), neoplasms (eg, primary intracranial tumors, local or distant metastases), inflammatory conditions (eg, orbital pseudotumor, sarcoidosis, Tolosa-Hunt syndrome), infectious etiologies (eg, fungal, mycobacterial), and other conditions (eg, microvascular infarcts secondary to diabetes, ophthalmoplegic migraine, giant cell arteritis). A systematic approach to the evaluation of painful ophthalmoplegia can lead to prompt recognition of serious disorders that if left untreated, can be associated with significant morbidity or mortality. Inflammatory conditions such as Tolosa-Hunt syndrome and orbital pseudotumor are highly responsive to corticosteroids, but should be diagnoses of exclusion.

Original languageEnglish (US)
Pages (from-to)321-329
Number of pages9
JournalCurrent pain and headache reports
Issue number4
StatePublished - Aug 2004

ASJC Scopus subject areas

  • Clinical Neurology
  • Anesthesiology and Pain Medicine


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