ABSTRACT
Tolosa-Hunt Syndrome is a rare disease characterized by painful ophthalmoplegia affecting third, fourth, and/or sixth cranial nerve caused by non-specific inflammation in the cavernous sinus or superior orbital fissure of unknown etiology. We presented a 67-year-old female with Tolosa-Hunt Syndrome. She had a right-sided headache and periorbital pain with double vision. Examination showed right-sided ptosis, right-sided trochlear and abducens nerve palsy, and partial right-sided oculomotor nerve palsy with hypoesthesia in the area of the ophthalmic division of the trigeminal nerve. Magnetic resonance imaging of head and orbit showed altered signal intensity changes in the optic nerve and lateral rectus muscle. After steroid therapy, pain and ptosis were significantly improved in 72 hours. Tolosa-Hunt Syndrome is a diagnosis of exclusion, with clinical presentation, normal investigations, magnetic resonance imaging findings, and response to steroid therapy crucial in making the diagnosis.
Subject(s)
Blepharoptosis , Tolosa-Hunt Syndrome , Aged , Blepharoptosis/diagnosis , Blepharoptosis/etiology , Female , Humans , Magnetic Resonance Imaging , Pain , Tolosa-Hunt Syndrome/complications , Tolosa-Hunt Syndrome/diagnosisABSTRACT
INTRODUCTION: Mental health and physical health are interconnected. Attitude of medical professionals towards mentally ill affects the quality of care the patient receives. Today's medical students are tomorrow's medical practitioner. We conducted a study in a teaching hospital to assess the attitude towards mental illness among medical students and interns. METHODS: A descriptive cross sectional study was performed in 265 students in Kathmandu Medical College in August, 2017. Opinion about Mental Illness (OMI) questionnaire developed by Cohen and Struening was used. RESULTS: Of the total participants, 132 (49.8%) were male and 133 (50.2%) were female. Medical students were more authoritarian, more benevolent and believed that mental illness is like any other medical illness. They showed neutral attitude in terms of social restriction of mentally ill and interpersonal relationship as a cause of mental illness. CONCLUSIONS: Positive attitude was seen only in terms of benevolence and mental hygiene ideology. Effective teaching and training programs is necessary to bring in positive attitude change towards mentally ill among medical students.
