Tolosa-Hunt syndrome revealing Burkitt lymphoma in an HIV-seropositive patient

Background: Tolosa-Hunt's syndrome is characterised by a painful, uni or bilateral, recurrent ophthalmoplegia, involving one or several ocular motor nerves. It is secondary to non-specific granulomatous infiltration of the cavernous sinus. It regresses rapidly with systemic corticosteroid therapy. Lymphomas involving the cavernous sinus may mimic a Tolosa-Hunt syndrome and hence delay diagnosis.

Methods: A 39 year-old HIV-seropositive male consulted for a painful ophthalmoplegia revealing a generalised Burkitt lymphoma evoking Tolosa-Hunts' syndrome. The outcome was unfavourable.

Conclusions: When confronted with a clinical picture evoking Tolosa-Hunt's syndrome, thorough examination is required to eliminate the localisation of a lymphoma or meningioma.