Painful Ophthalmoplegia

Causes of cavernous sinus syndrome producing painful ophthalmoplegia:

• 1. Trauma

  2. Vascular

     1. Intracavernous carotid artery aneurysm

     2. Posterior cerebral artery aneurysm

     3. Carotid-cavernous fistula

     4. Carotid-cavernous sinus thrombosis

  3. Neoplasm

• • 1. Primary intracranial tumor

       1. Pituitary adenoma

       2. Meningioma

       3. Craniopharyngioma

       4. Sarcoma

       5. Neurofibroma

       6. Gasserian ganglion neuroma

       7. Epidermoid

       8. Hemangioma/hemangiopericytoma

       9. Eosinophilic granuloma

       10. Neuroblastoma

    2. Primary cranial tumor

• • • 1. Chordoma

      2. Chondroma

      3. Giant cell tumor

• • 3. Local metastases

• • • 1. Nasopharyngeal tumor

      2. Cylindroma

      3. Adamantinoma

      4. Squamous cell carcinoma

• • 4. Distant metastases

• • • 1. Lymphoma

      2. Multiple myeloma

      3. Carcinomatous metastases

• 4. Inflammation

• • 1. Bacterial: sinusitis, mucocele, periostitis

    2. Viral: herpes zoster

    3. Fungal: mucormycosis, aspergillosis

    4. Spirochetal: T.pallidum

    5. Mycobacterial: Mycobacterium tuberculosis

    6. Unknown cause: sarcoidosis, Wegener’s granulomatosis, Tolosa-Hunt syndrome