Tolosa-hunt Syndrome Following COVID-19 Pandemic: A Case Series Describing the Clinical Presentations and Response to Steroids

Tolosa-Hunt Syndrome is a rare condition characterised by unilateral periorbital headache with ophthalmoplegia caused by inflammation of the superior orbital fissure or cavernous sinus. There has been an increase in cases of Tolosa-Hunt Syndrome following the Coranavirus Disease-19 (COVID-19) pandemic. This case series describes the clinical details of three such patients and their response to steroid therapy. The first patient was a 61-year-old woman with a history of post COVID infection who had received two doses of the COVID vaccine. She presented with second, third, fifth, and sixth cranial nerve palsies of the left eye. She received steroid therapy, following which there was recovery of extraocular movements and improvement in vision. The second patient was a 43-year-old male who had received two doses of the COVID vaccine. He presented with multiple cranial nerve palsies affecting the second, partial third, and fifth cranial nerves of the left eye. He reported symptomatic relief and improvement in ptosis after steroid therapy. The third patient was a 40-year-old male who had received two doses of the COVID vaccine. He presented with painful external ophthalmoplegia involving the second, third, fourth, and sixth cranial nerves of the right eye. Following steroid therapy, he experienced symptomatic relief and recovery of extraocular movements.