Tolosa-Hunt综合征的临床分析

Study on the etiology,clinical manifestation and neuroimaging examinations of Tolosa-Hunt syndrome

目的通过回顾性分析Tolosa-Hunt综合征（THS）病例的病因、临床表现、影像学检查结果,为在临床明确诊断该病寻找到有效的方法。方法对2001年~2009年我院确诊的22例THS患者的临床表现（一般情况、首发症状、脑神经损伤情况）、实验室检查、神经影像学检查结果及治疗方法和预后进行回顾性分析。结果 22例THS患者急性或亚急性起病,头痛首发为主,伴多组颅神经损害,大部分病例病变侧海绵窦有影像学的异常改变。激素治疗有效,治疗后数周至数月内临床症状及影像学异常均明显好转或消失,但可留有颅神经麻痹后遗症及复发。结论 THS患者主要病因考虑为免疫反应有关的非特异性慢性炎症,CT、MR I检查对其确诊有重要价值。根据临床特征、病因及影像学特点进行综合分析,有利于提高诊断率和制定治疗方案。

Objective To retrospectively study the etiology,clinical manifestation and neuroimaging to make a definite diagnosis of Tolosa-Hunt syndrome（THS）.Methods The clinical manifestation（general state of health,first sign,cranial nerve injury）,laboratory examination,neuroimaging,remedy and prognosis data of such 22 cases of Tolosa-Hunt syndrome hospitalized from 2001 to 2009 and literatures were retrospectively reviewed.Results 22 patients was acute or subacute onset.First sign was headache and cranial nerves injury.There was some abnormal radiological appearance in main cases of Tolosa-Hunt syndrome.The treatment using corticosteroid was effective but some of them were resulting in cranial nerve paralysis and recurred.Mainly cases having positive results by the first time examination had obviously diminished or disappeared.Conclusion The study showed that the etiology of nonspecific inflammation was supported again.CT and MRI present important value for the diagnosis.Comprehensive analysis both on clinical manifestations,etiology and neuroimaging examinations of Tolosa-Hunt syndrome will make for enhancing the diagnose rate and enacting therapeutic schedule.