WordNet

yaw back and forth about a flight path; "the planes nose yawed"
the pursuit and killing or capture of wild animals regarded as a sport (同)hunting
the work of finding and killing or capturing animals for food or pelts (同)hunting
an association of huntsmen who hunt for sport (同)hunt club
an instance of searching for something; "the hunt for submarines"
pursue for food or sport (as of wild animals); "Goering often hunted wild boars in Poland"; "The dogs are running deer"; "The Duke hunted in these woods" (同)run, hunt down, track down
chase away, with as with force; "They hunted the unwanted immigrants out of the neighborhood"
oscillate about a desired speed, position, or state to an undesirable extent; "The oscillator hunts about the correct frequency"
search (an area) for prey; "The King used to hunt these forests"
seek, search for; "She hunted for her reading glasses but was unable to locate them"
a pattern of symptoms indicative of some disease
a complex of concurrent things; "every word has a syndrome of meanings"
Englishman and Pre-Raphaelite painter (1827-1910) (同)Holman Hunt, William Holman Hunt
British writer who defended the Romanticism of Keats and Shelley (1784-1859) (同)Leigh Hunt, James Henry Leigh Hunt
United States architect (1827-1895) (同)Richard Morris Hunt
a member of a nomadic people who invaded Europe in the 4th century

PrepTutorEJDIC

〈野生の鳥・動物〉‘を'『狩る』,〈獲物のいる場所〉‘を'狩る,〈馬・犬など》‘を'狩猟に使う / 〈物・仕事など〉‘を'捜す,見つけようとする / (…を求めて)〈場所〉‘を'くまなく捜す《+『名』+『for』+『名』》 / (…から)…‘を'迫いやる《+『名』+『away』(+『away』+『名』)+『from』(off, out of』)+『名』》 / 『狩りをする』 / (…を)捜し求める《+『for』(『after』)+『名』》 / (…を求めて…を)くまなそ捜す《+『in』(『through』)+『名』+『for』+『名』》 / 『狩り』,狩猟;《英》キツネ狩り / 狩猟隊(会) / (…の)捜索;追求《+『for』+『名』》
(疾患の徴候となる一群の)症徴候,症候群 / (事件・社会的状態などのパターンを示す)徴候形態
フン族(4‐5世紀ヨーロッパに浸入したアジアの遊牧民族) / 《しばしばh-》(文化の)破壊者,野蛮人

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2013/11/19 11:55:11」(JST)

wiki en

Tolosa–Hunt syndrome (THS) is a rare disorder characterized by severe and unilateral headaches with extraocular palsies, usually involving the third, fourth, fifth, and sixth cranial nerves, and pain around the sides and back of the eye, along with weakness and paralysis (ophthalmoplegia) of certain eye muscles.^[1]

In 2004, the International Headache Society provided a definition of the diagnostic criteria which included granuloma.^[2]

Causes[edit]

The exact cause of THS is not known, but the disorder is thought to be, and often assumed to be, associated with inflammation of the areas behind the eyes (cavernous sinus and superior orbital fissure).

Signs and symptoms[edit]

Symptoms are usually limited to one side of the head, and in most cases the individual affected will experience intense, sharp pain and paralysis of muscles around the eye.^[3] Symptoms may subside without medical intervention, yet recur without a noticeable pattern.^[4]

In addition, affected individuals may experience paralysis of various facial nerves and drooping of the upper eyelid (ptosis). Other signs include double vision, fever, chronic fatigue, vertigo or arthralgia. Occasionally the patient may present with a feeling of protrusion of one or both eyeballs (exophthalmos).^[3]^[4]

Diagnosis[edit]

THS is usually diagnosed via exclusion, and as such a vast amount of laboratory tests are required to rule out other causes of the patient's symptoms.^[3] These tests include a complete blood count, thyroid function tests and serum protein electrophoresis.^[3] Studies of cerebrospinal fluid may also be beneficial in distinguishing between THS and conditions with similar signs and symptoms.^[3]

MRI scans of the brain and orbit with and without contrast, magnetic resonance angiography or digital subtraction angiography and a CT scan of the brain and orbit with and without contrast may all be useful in detecting inflammatory changes in the cavernous sinus, superior orbital fissure and/or orbital apex.^[3] Inflammatory change of the orbit on cross sectional imaging in the absence of cranial nerve palsy is described by the more benign and general nomenclature of orbital pseudotumor.

Sometimes a biopsy may need to be obtained to confirm the diagnosis, as it is useful in ruling out a neoplasm.^[3]

Differentials to consider when diagnosing THS include craniopharyngioma, migraine and meningioma.^[3]

Treatment[edit]

Treatment of THS is usually completed using corticosteroids (often prednisolone) and immunosuppressive agents (such as methotrexate or azathioprine).^[3] Corticosteroids act as analgesia and reduce pain (usually within 24–72 hours), as well as reducing the inflammatory mass, whereas immunosuppressive agents help reduce the autoimmune response.^[3] Treatment is then continued in the same dosages for a further 7–10 days and then tapered slowly.^[3]

Radiotherapy has also been proposed.^[5]

Prognosis[edit]

The prognosis of THS is usually considered good. Patients usually respond to corticosteroids, and spontaneous remission can occur, although movement of ocular muscles may remain damaged.^[3] Roughly 30–40% of patients who are treated for THS experience a relapse.^[3]

Epidemiology[edit]

THS is uncommon in both the United States and internationally. In New Zealand, there is only one recorded case .^[3] Both genders, male and female, are affected equally, and it typically occurs around the age of 60.^[1]

References[edit]

^ ^a ^b "Tolosa–Hunt syndrome". Who Named It. Retrieved 2008-01-21.
^ La Mantia L, Curone M, Rapoport AM, Bussone G (2006). "Tolosa–Hunt syndrome: critical literature review based on IHS 2004 criteria". Cephalalgia 26 (7): 772–81. doi:10.1111/j.1468-2982.2006.01115.x. PMID 16776691.
^ ^a ^b ^c ^d ^e ^f ^g ^h ⁱ ^j ^k ^l ^m ⁿ <Danette C Taylor, DO. "Tolosa–Hunt syndrome". eMedicine. Retrieved 2008-01-21.
^ ^a ^b "Tolosa Hunt Syndrome". National Organization for Rare Disorders, Inc. Retrieved 2008-01-21.
^ Foubert-Samier A, Sibon I, Maire JP, Tison F (2005). "Long-term cure of Tolosa–Hunt syndrome after low-dose focal radiotherapy". Headache 45 (4): 389–91. doi:10.1111/j.1526-4610.2005.05077_5.x. PMID 15836581.

Wikimedia Commons has media related to Tolosa–Hunt syndrome.

UpToDate Contents

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1. トロサハント症候群 tolosa hunt syndrome
2. 複視の概要 overview of diplopia
3. 敗血症性硬膜静脈洞血栓症 septic dural sinus thrombosis
4. 頚動脈海綿静脈洞瘻 carotid cavernous fistulas
5. 眼窩蜂巣炎 orbital cellulitis

English Journal

Painful Ophthalmoplegia of the Right Eye in a 20-Year-Old Man.

Beckham S, Kim H, Truong A.SourceDepartment of Emergency Medicine, Los Angeles County + University of Southern California (LAC+USC) Medical Center, Los Angeles, California.
The Journal of emergency medicine.J Emerg Med.2012 Sep 12. pii: S0736-4679(12)00871-2. doi: 10.1016/j.jemermed.2012.07.049. [Epub ahead of print]
BACKGROUND: Painful ophthalmoplegia is an infrequent but very important presentation in the acute care setting and requires a thorough neurologic evaluation to determine its cause. This clinical sign has a large differential and generally indicates a serious cerebrovascular process.CASE REPORT: We d
PMID 22981660

Tolosa-Hunt syndrome--diagnostic problem of painful ophthalmoplegia.

Paović J, Paović P, Bojković I, Nagulić M, Sredović V.SourceInstitute for Eye Disease, Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia. velikiceda@yahoo.com
Vojnosanitetski pregled. Military-medical and pharmaceutical review.Vojnosanit Pregl.2012 Jul;69(7):627-30.
BACKGROUND: Tolosa-Hunt syndrome (THS) is an uncommon disease caused by non-specific inflammation of the cavernous sinus, superior orbital fissure and the apex of the orbit. The disease is characterized by periorbital pain, paresis of the bulbomotor and quick response to steroid treatment. The orbit
PMID 22838177

Japanese Journal

Tolosa-Hunt 症候群の再発を認めた2型糖尿病患者の一例

小林秀俊,太田明雄,川田剛裕,加藤浩之,古川健太郎,方波見卓行,田中逸
糖尿病 53(6), 402-405, 2010-06-30
NAID 10026604442

Metastatic Skull Base Tumor From Thymic Carcinoma Mimicking Tolosa-Hunt Syndrome : —Case Report—

TSUTSUMI Satoshi,ABE Yusuke,YASUMOTO Yukimasa,SHIONO Saori,ITO Masanori
Neurologia medico-chirurgica 50(6), 499-502, 2010
A 39-year-old male without contributory medical history had sustained progressive double vision, ptosis, and trigeminal pain for 2 weeks. Physical examination revealed total ophthalmoplegia and visual …
NAID 130000309340

Related Pictures

★リンクテーブル★

リンク元	「上眼窩裂症候群」「THS」
関連記事	「hunt」「syndrome」

「上眼窩裂症候群」

Tolosa–Hunt syndrome
	Classification and external resources
	; Neuro-ophthalmologic examination showing ophthalmoplegia in a patient with Tolosa–Hunt syndrome, prior to treatment. The central image represents forward gaze, and each image around it represents gaze in that direction (for example, in the upper left image, the patient looks up and right; the left eye is unable to accomplish this movement). The examination shows ptosis of the left eyelid, exotropia (outward deviation) of the primary gaze of the left eye, and paresis (weakness) of the left third, fourth and sixth cranial nerves.
ICD-10	G44.850
ICD-9	378.55
DiseasesDB	31164
eMedicine	neuro/373
MeSH	D020333

　　[★]

英: superior orbital fissure syndrome
同: orbital apex syndrome、間欠性有痛性眼筋麻痺 intermittent painful ophthalmoplegia、トロサ・ハント症候群 Tolosa-Hunt症候群 Tolosa-Hunt syndrome
関: 上眼窩裂、動眼神経麻痺

[show details]

トローザ・ハント症候群 : 35 件
トローサ・ハント症候群 : 65 件
トロサ・ハント症候群 : 65 件
トロザ・ハント症候群 : 65 件

トローザ・ハント症候群 Tolosa : 18 件
トローサ・ハント症候群 Tolosa : 1 件
トロサ・ハント症候群 Tolosa : 24 件
トロザ・ハント症候群 Tolosa : 6 件

病因

海綿静脈洞部に形成される非特異的炎症性肉芽腫により近辺の構造物が障害される

上眼窩裂を通過する構造

血管

上眼静脈

神経

総腱輪の外

総腱輪の内

動眼神経 CN III
鼻毛様体神経 CN V1
外転神経 CN VI
交感神経

症状

眼痛
頭痛
脳神経障害(CN III, CN IV, CN V1, CN VI)

治療

副腎皮質コルチコイド

「THS」

　　[★]

「hunt」

　　[★] 　　　　　　　　　　　

「syndrome」

　　[★]

n.

症候群

[wni-1] "Tolosa–Hunt syndrome". Who Named It. Retrieved 2008-01-21.

[pmid16776691-2] La Mantia L, Curone M, Rapoport AM, Bussone G (2006). "Tolosa–Hunt syndrome: critical literature review based on IHS 2004 criteria". Cephalalgia 26 (7): 772–81. doi:10.1111/j.1468-2982.2006.01115.x. PMID 16776691.

[eMedicine-3] ^ ^a ^b ^c ^d ^e ^f ^g ^h ⁱ ^j ^k ^l ^m ⁿ <Danette C Taylor, DO. "Tolosa–Hunt syndrome". eMedicine. Retrieved 2008-01-21.

[nord-4] "Tolosa Hunt Syndrome". National Organization for Rare Disorders, Inc. Retrieved 2008-01-21.

[pmid15836581-5] Foubert-Samier A, Sibon I, Maire JP, Tison F (2005). "Long-term cure of Tolosa–Hunt syndrome after low-dose focal radiotherapy". Headache 45 (4): 389–91. doi:10.1111/j.1526-4610.2005.05077_5.x. PMID 15836581.

匿名

検索

案内

案内

Tolosa-Hunt syndrome