Optic nerve swelling in a case of Tolosa-Hunt syndrome

A 52-year-old male presented with headache, pain in the left orbit, swollen left upper eyelid and diplopia since 2 weeks before. His left eye showed conjunctival injection, chemosis and total ophthalmoplegia. Computerized tomography (CT) and magnetic resonance imaging (MRI) showed swelling of the left optic nerve. All the subjective symptoms spontaneously disappeared 4 days later. CT and MRI findings normalized 3 months later. These findings led to the diagnosis of Tolosa-Hunt syndrome. This case illustrates that swelling of the optic nerve may occur in this syndrome, probably secondary to venous stasis in orbital tissues.