ABSTRACT
Tolosa-Hunt syndrome (THS) is a clinical syndrome of painful ophthalmoplegia associated with an idiopathic inflammation in the superior orbital fissure or cavernous sinus. We report a 61-year-old woman with recurrent THS. She had been treated with steroids for the painful ophthalmoplegia. After a symptom-free period, she developed similar symptoms. The postcontrast brain MRI showed increased signal in the cavernous sinus, which was also seen in the previous MRI.
Subject(s)
Female , Humans , Middle Aged , Brain , Cavernous Sinus , Inflammation , Magnetic Resonance Imaging , Ophthalmoplegia , Orbit , Steroids , Tolosa-Hunt SyndromeABSTRACT
Botulium toxin A has been used therapeutically in humans for over 20 years for a variety of medical indications. Some wrinkle and unsightly facial expressions are due to hyperkinetic muscle. For the past year, the author has injected it for variant purpose, so we describe the our experience with the variant extended use of the toxin including correction for just dynamic wrinkle, used with subperiosteal face lifting or peeling, post-traumatic twitching, and facial paralysis and relevant anatomy are discussed. Also we have another concept about muscle anatomy which have superficial and deep portion. The superficial portion is for harmonious action with SMAS during facial expression, which is also related to fine wrinkle, and the deep portion play role gross movement. Botulium toxin is safe and effective in varient field without complication. Its use is associated with a high degree of patient and physician satisfaction.