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A 39-year-old gravida-2 para-1 woman with prior chronic intake of combined oral contraceptives (COC) suffered two episodes of painful ophthalmoplegia\u2014the first event with spontaneous remission and the relapse occurring during pregnancy and with complete resolution following steroid treatment. MRI revealed a postinflammatory mass at the junction of the left orbital apex and anterior cavernous sinus, supporting the diagnosis of THS. To our knowledge, this is the first report of a THS relapse occurring during pregnancy following a chronic history of COC intake. This case adds to the growing evidence supporting the relationship between immune and hormonal factors that may be present during pregnancy and the disease pathogenesis of THS.<\/jats:p>","DOI":"10.1136\/bcr-2020-238944","type":"journal-article","created":{"date-parts":[[2021,1,18]],"date-time":"2021-01-18T12:27:24Z","timestamp":1610972844000},"page":"e238944","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Tolosa-Hunt syndrome relapse during pregnancy following chronic intake of combined oral contraceptives"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9745-9384","authenticated-orcid":false,"given":"Bernadeth Lyn Cal","family":"Piamonte","sequence":"first","affiliation":[{"name":"Department of Neurosciences, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila, Metro Manila, Philippines"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keno Lorenzo","family":"Ong","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila, Metro Manila, Philippines"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alvin Rae","family":"Cenina","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila, Metro Manila, Philippines"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,1,18]]},"reference":[{"key":"2025082804253014000_14.1.e238944.1","doi-asserted-by":"crossref","unstructured":"Binder DK , Sonne DC , Fischbein NJ . 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