The demographics of Tolosa-Hunt syndrome in Qatar

<h3>Background</h3><p dir="ltr">Tolosa Hunt syndrome (THS) is a rare disease that manifests mainly as painful unilateral ophthalmoplegia. It is caused by an inflammatory process of unknown aetiology within the cavernous sinus with a rare intracranial extension. The Intern...

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Main Author: Fateen Ata (12217764) (author)
Other Authors: Zohaib Yousaf (9617058) (author), Suresh Nalaka Menik Arachchige (17269264) (author), Saman Rose (17269267) (author), Awni Alshurafa (15468195) (author), Bassam Muthanna (14777407) (author), Ammara Bint I Bilal (17269270) (author), Ahmed El Beltagi (17269273) (author), Muhammad Zahid (4510696) (author)
Published: 2021
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Summary:<h3>Background</h3><p dir="ltr">Tolosa Hunt syndrome (THS) is a rare disease that manifests mainly as painful unilateral ophthalmoplegia. It is caused by an inflammatory process of unknown aetiology within the cavernous sinus with a rare intracranial extension. The International Classification of Headache Disorders (ICHD)- 3 diagnostic criteria aids in its diagnosis. There is limited literature on its varied presentations, diagnosis, and management. Steroids are used in the treatment of THS with varied success.</p><h3>Methods</h3><p dir="ltr">We conducted a single-center-retrospective-study and included all patients admitted with a diagnosis of THS from January 2015 to December 2020. Descriptive and summary statistics were used to describe the study cohort's socio-demographic parameters.</p><h3>Results</h3><p dir="ltr">Among 31 THS patients (predominantly Asians (18) and Arabs (9)), visual disturbance was commonest presenting complaint. Third-nerve paralysis was seen in 70.9% cases. Magnetic-resonance-imaging (MRI) was abnormal in 64.5%. 93.5% patients received steroids, with a response-rate of 70.9% and a recurrence-rate of 9.7%. A previous history of THS and female gender were associated with recurrence (p-value 0.009 and 0.018). Recurrence was seen in 66.7% fully recovered and 33.3% partially recovered cases (p-value 0.04). Among the benign and inflammatory subtypes of THS, the ICHD-3 criteria were applicable in 85% of inflammatory THS.</p><h3>Conclusions</h3><p dir="ltr">THS is a rare disease with ethnic variation in presentation and response to treatment. In our cohort female gender and a previous history of THS were associated with recurrence. ICHD-3 diagnostic criteria had a higher validity in our patients compared to prior studies, especially among the inflammatory THS.</p><h2>Other Information</h2><p dir="ltr">Published in: eNeurologicalSci<br>License: <a href="http://creativecommons.org/licenses/by/4.0/" target="_blank">http://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1016/j.ensci.2021.100359" target="_blank">https://dx.doi.org/10.1016/j.ensci.2021.100359</a></p>