Tolosa hunt sindrome due to actinomycosis of the cavernous sinus: a case report and review of literature

Tolosa hunt sindrome is characterized by ophtalmoplegia with unilateral, severe retro-orbital pain associated to a low grade granulomatous inflammatory process occupying the cavernous sinus or the superior orbital fessure. The etiology in unknown and diagnosis is based upon good clinical response to steroid treatment. Differential diagnosis include neoplasm, trauma, aneurysms, infectious and inflammatory diseases. We report a case of painful ophthalmoplegia caused by actinomycosis of the cavernous sinus.