r-n-jРоссийский неврологический журналRussian neurological journal2658-79472686-7192МИА10.30629/2658-7947-2022-27-6-77-83r-n-j-375Research ArticleИССЛЕДОВАНИЯ И КЛИНИЧЕСКИЕ НАБЛЮДЕНИЯCLINICAL RESEARCHES AND CASE REPORTSРецидивирующее течение болевой офтальмоплегической невропатииReccurent painful ophthalmoplegic neuropathyhttps://orcid.org/0000-0002-7682-6672МаксимоваМ. Ю.MaksimovaM. Yu.

Максимова Марина Юрьевна

Москва

Moscow

ncnmaximova@mail.ruhttps://orcid.org/0000-0002-2704-6282ИллариошкинС. Н.IllarioshkinS. N.

Москва

Moscow

snillario@gmail.comhttps://orcid.org/0000-0001-5823-9434СавицкаяИ. А.SavizkayaI. A.

Москва

Moscow

ФГБНУ «Научный центр неврологии»; ФГБОУ ВО «Московский государственный медико-стоматологического университет им. А.И. Евдокимова» Минздрава РоссииРоссияResearch Center of Neurology, Мinistry of Education and Science of Russia; A.I. Evdokimov Moscow State University of Medicine and Dentistry, Ministry of Health of RussiaRussian FederationФГБНУ «Научный центр неврологии»РоссияResearch Center of Neurology, Мinistry of Education and Science of RussiaRussian Federation2022110120232767783Copyright © Максимова М.Ю., Иллариошкин С.Н., Савицкая И.А., 20232023Максимова М.Ю., Иллариошкин С.Н., Савицкая И.А.Maksimova M.Y., Illarioshkin S.N., Savizkaya I.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.r-n-j.com/jour/article/view/375

Болевая офтальмоплегическая невропатия (синдром Толосы–Ханта, СТХ) развивается при неспецифическом процессе гранулематозного воспаления в стенках пещеристого синуса (ПС) и пещеристой части внутренней сонной артерии. Характеризуется сочетанием дисфункции одного или нескольких глазодвигательных нервов с болевым синдромом пери- и ретроорбитальной локализации, спонтанными ремиссиями и рецидивами. Глазодвигательные нарушения совпадают по времени с появлением боли или возникают в течение 2 нед. после ее начала. Выявление гранулематозного воспаления в стенках ПС и пещеристой части внутренней сонной артерии, в области верхней глазничной щели или полости глазницы при МРТ или при проведении биопсии подтверждают диагноз синдрома СТХ. Лечение кортикостероидами приводит к быстрому (в течение 72 ч) уменьшению боли и восстановлению функций глазодвигательных нервов. Нами представлен случай рецидивирующего течения СТХ у мужчины 47 лет. При МРТ обнаружен неспецифический воспалительный процесс в стенках левого ПС c переходом на левую верхнюю глазничную щель, а также накопление контрастного вещества утолщенной твердой мозговой оболочкой.

Reccurent painful ophthalmoplegic neuropathy (the Tolosa–Hunt syndrome) occurs due to a nonspecific granulomatous infl ammation of the walls of the cavernous sinus and the intracavernous segment of the internal carotid artery. It consists of one or more oculomotor nerves dysfunction associated with peri- and retroorbital pain; spontaneous remissions and relapses are typical. Oculomotor nerve disorders may coincide with the onset of pain or follow it within a period of up to 2 weeks. Demonstration of granulomatosis in the walls of the cavernous sinus and the intracavernous segment of the internal carotid artery, superior orbital fissure or orbit by MRI or biopsy confi rms the diagnosis of Tolosa–Hunt syndrome (THS). Corticosteroid therapy leads to rapid (within 72 hours) pain relief and recovery of oculomotor nerve function. Here, we report a case of reccurent THS in 47-year-old men. Neuroimaging schowed a nonspecific inflammation in the superior orbital fissure-cavernous sinus region on left side and contrast-enhanced thickening dura mater.

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The authors declare that there are no conflicts of interest present.