{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T16:17:49Z","timestamp":1787847469932,"version":"build-2784847793"},"reference-count":10,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:sec>\n                    <jats:title\/>\n                    <jats:p>The Tolosa\u2013Hunt syndrome (THS) is caused by granulomatous inflammation in the cavernous sinus, superior orbital fissure, or orbit characterized by painful ophthalmoplegia. Here, we report a case of recurrent THS in a 48-year-old female, who initially showed a poor response to low-dose steroids. Each episode involved different cranial nerves and painful ophthalmoplegia. Neuroimaging showed enhancement in the right cavernous sinus. The patient was treated with glucocorticoid pulse therapy and azathioprine. THS was previously considered to be responsive to glucocorticoids. This report demonstrates a case of THS with poor response to steroids and unique presentation of frequent recurrence with different cranial nerve involvement.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/tcmj.tcmj_137_20","type":"journal-article","created":{"date-parts":[[2021,6,22]],"date-time":"2021-06-22T05:20:28Z","timestamp":1624339228000},"page":"314-316","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":5,"title":["Recurrent Tolosa\u2013Hunt syndrome"],"prefix":"10.4103","volume":"33","author":[{"given":"Phyo-Wai","family":"Thu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu-Ming","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weng-Ming","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-17-20240828","doi-asserted-by":"crossref","first-page":"746","DOI":"10.1111\/j.1468-2982.2005.00924.x","article-title":"Tolosa-Hunt syndrome extending in the cerebello-pontine angle","volume":"25","author":"Iaconetta","year":"2005","journal-title":"Cephalalgia"},{"key":"R2-17-20240828","doi-asserted-by":"crossref","first-page":"577","DOI":"10.1136\/jnnp.71.5.577","article-title":"The Tolosa-Hunt syndrome","volume":"71","author":"Kline","year":"2001","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"R3-17-20240828","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1016\/j.yebeh.2018.07.018","article-title":"\u201cIctal epileptic headache\u201d and the revised International Headache Classification (ICHD-3) published in Cephalalgia 2018, vol. 38 (1) 1-211: Not just a matter of definition!","volume":"87","author":"Parisi","year":"2018","journal-title":"Epilepsy Behav"},{"key":"R4-17-20240828","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1007\/s11916-018-0705-5","article-title":"Relapsing Painful Ophthalmoplegic Neuropathy: No longer a \u201cMigraine,\u201d but Still a Headache","volume":"22","author":"Smith","year":"2018","journal-title":"Curr Pain Headache Rep"},{"key":"R5-17-20240828","doi-asserted-by":"crossref","first-page":"899","DOI":"10.1007\/s10072-015-2124-2","article-title":"The evaluation of ICHD-3 beta diagnostic criteria for Tolosa-Hunt syndrome: A study of 22 cases of Tolosa-Hunt syndrome","volume":"36","author":"Hao","year":"2015","journal-title":"Neurol Sci"},{"key":"R6-17-20240828","first-page":"263","article-title":"Recurrent multiple cranial nerve palsies (Tolosa-Hunt plus.)?","volume":"3","author":"Kansu","year":"1983","journal-title":"J Clin Neuroophthalmol"},{"key":"R7-17-20240828","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1055\/s-0028-1124023","article-title":"Multiple cranial neuropathies","volume":"29","author":"Carroll","year":"2009","journal-title":"Semin Neurol"},{"key":"R8-17-20240828","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1002\/mus.21958","article-title":"Recurrent multiple cranial nerve palsy and anti-GD1a antibodies","volume":"43","author":"Simon","year":"2011","journal-title":"Muscle Nerve"},{"key":"R9-17-20240828","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1046\/j.1468-2982.1992.1201045.x","article-title":"Recurrent Tolosa-Hunt syndrome","volume":"12","author":"Hannerz","year":"1992","journal-title":"Cephalalgia"},{"key":"R10-17-20240828","doi-asserted-by":"crossref","first-page":"e19882","DOI":"10.1097\/MD.0000000000019882","article-title":"Use of methotrexate in the management of recurrent Tolosa-Hunt syndrome: Two case reports","volume":"99","author":"Kwon","year":"2020","journal-title":"Medicine (Baltimore"}],"container-title":["Tzu Chi Medical Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/tcmj.tcmj_137_20","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T15:19:25Z","timestamp":1787843965000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/tcmj.tcmj_137_20"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7]]},"references-count":10,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2021]]}},"URL":"https:\/\/doi.org\/10.4103\/tcmj.tcmj_137_20","relation":{},"ISSN":["1016-3190"],"issn-type":[{"value":"1016-3190","type":"print"}],"subject":[],"published":{"date-parts":[[2021,7]]}}}