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Case Reports
. 2021 Jul 31;13(7):e16791.
doi: 10.7759/cureus.16791. eCollection 2021 Jul.

Tolosa-Hunt Syndrome Presenting After COVID-19 Vaccination

Tzu Ying Chuang  1 , Karina Burda  1 , Ephrem Teklemariam  2 , Kamran Athar  2
Affiliations
Case Reports

Tolosa-Hunt Syndrome Presenting After COVID-19 Vaccination

Tzu Ying Chuang et al. Cureus. .

Abstract

Coronavirus disease 2019 (COVID-19) infection is associated with a plethora of neurological complications. Newly developed vaccinations targeting the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral spike protein represent a great epidemiological promise with respect to the resolution of the pandemic. However, vaccinations are not without side effects and, in rare cases, have even been implicated in various autoimmune phenomena. In this report, we describe a case of Tolosa-Hunt syndrome (THS), a granulomatous inflammatory process of the cavernous sinus, occurring in a patient one week after getting COVID-19 vaccination. This rare diagnosis of exclusion must be considered in patients presenting with painful ophthalmoplegia.

Keywords: autoimmune neurology; covid-19; covid-19 vaccine; headache; headache disorders; neuro-immunology; neuro-ophthalmology; neuroinflammation.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. MRI of an inflammatory left cavernous sinus process consistent with Tolosa-Hunt syndrome
T2 axial FLAIR (a) and FSE coronal (c) images showing bulky perineural tissue extending into the left cavernous sinus. The perineural tissue has heterogeneous post-contrast enhancement and slightly decreased enhancement centrally consistent with a component of thrombosis on post-contrast T1 axial (b) and coronal (d) images MRI: magnetic resonance imaging; FLAIR: fluid-attenuated inversion recovery; FSE: fast spin-echo
See this image and copyright information in PMC

References

    1. Acute disseminated encephalomyelitis: an update. Menge T, Hemmer B, Nessler S, et al. Arch Neurol. 2005;62:1673–1680. - PubMed
    1. Bilateral superior ophthalmic vein thrombosis, ischaemic stroke, and immune thrombocytopenia after ChAdOx1 nCoV-19 vaccination. Bayas A, Menacher M, Christ M, Behrens L, Rank A, Naumann M. Lancet. 2021;397:0. - PMC - PubMed
    1. Thrombotic thrombocytopenia after ChAdOx1 nCov-19 vaccination. Greinacher A, Thiele T, Warkentin TE, Weisser K, Kyrle PA, Eichinger S. N Engl J Med. 2021;384:2092–2101. - PMC - PubMed
    1. Myocarditis following immunization with mRNA COVID-19 vaccines in members of the US military (Epub ahead of print) Montgomery J, Ryan M, Engler R, et al. JAMA Cardiol. 2021 - PMC - PubMed
    1. Patients with acute myocarditis following mRNA COVID-19 vaccination (Epub ahead of print) Kim HW, Jenista ER, Wendell DC, et al. JAMA Cardiol. 2021 - PMC - PubMed

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