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

Introduction 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. Observation 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. Conclusion When confronted with a clinical picture evoking Tolosa-Hunt's syndrome, thorough examination is required to eliminate the localisation of a lymphoma or meningioma. (C) 2003, Masson, Paris.