Painful Ophthalmoplegia Unmasked: A Case of Tolosa-Hunt Syndrome

The diagnosis of THS remains challenging because its presenting symptoms overlap with several potentially life-threatening conditions, including cavernous sinus thrombosis, intracerebral aneurysm, neoplasia, giant cell arteritis and inflammatory disorders such as sarcoidosis and granulomatosis with polyangiitis. Consequently, THS remains a diagnosis of exclusion and requires careful investigation to rule out the broad differential diagnosis of painful ophthalmoplegia.