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Title

An atypical case of acute unilateral complete external ophthalmoplegia.

Purpose	To describe a patient who presented with atypical acute unilateral complete external ophthalmoplegia.
Methods	A case report and a complete review of the literature.
Results	A 70-year-old women presented with acute unliteral complete external ophthalmoparesis, followed in the next few days by unilateral complete external ophthalmoplegia. The patient had already presented with two crises similar before with full recovery after few days of corticotherapy. After a normal complete systemic workup including biology, MRI, angio-CT and lumbar puncture, a diagnosis of Tolosa-Hunt syndrome was retained. The patient had a full recovery but this time she did not respond as quickly to the corticotherapy.
Conclusion	This atypical case of acute unilateral complete external ophthalmoplegia required a complete review of the literature. We think that, as some authors have already mentioned, the criteria of Tolosa-Hunt syndrome should be reviewed. In addition, the delayed response to corticosteroids during this episode also raises the question of a cortico-resistance.
Conflict of interest	No

Authors 1

Last name	DELVAULX
Initials	Ph.
Department	ERASME
City	BRUXELLES

Authors 2

Last name	YOUSSFI
Initials	A.
Department	ERASME
City	BRUXELLES