Tolosa-Hunt Syndrome Medication

Updated: May 04, 2021
  • Author: Danette C Taylor, DO, MS, FACN; Chief Editor: Niranjan N Singh, MBBS, MD, DM, FAHS, FAANEM  more...
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Medication Summary

Steroids are used to treat the inflammation of Tolosa-Hunt syndrome. Pain relief usually occurs rapidly, ie, within 24–72 hours. [12] Continue treatment at the initial dose for a short time (ie, 7–10 d) after pain resolves, then taper gradually. If no response to steroid therapy has occurred within 72 hours, the diagnosis of Tolosa-Hunt syndrome should be reevaluated.

If a patient is unable to tolerate steroid therapy, other immunosuppressive therapy may be considered.



Class Summary

Reduce pain and inflammation; diminish the size of the inflammatory mass.

Prednisone (Sterapred)

May decrease inflammation by reversing increased capillary permeability and suppressing PMN activity. Stabilizes lysosomal membranes and also suppresses lymphocytes and antibody production.


Immunosuppressive agents

Class Summary

Decrease autoimmune reaction.

Methotrexate (Trexall)

Antimetabolite used to treat many autoimmune processes. The mode of action is not known; this drug does interfere with DNA synthesis.

Azathioprine (Imuran)

Immunosuppressive agent that works primarily on T cells. Works very slowly; may require 6-12 mo of trial prior to effect. Up to 10% of patients may have idiosyncratic reaction disallowing use. Do not allow WBC count to drop below 3000/µL or lymphocyte count to drop below 1000/µL.