Influence of progesterone and clomiphene on Tolosa–Hunt syndrome
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Tolosa–Hunt syndrome (THS) is a condition of painful ophthalmoplegia due to a nonspecific granulomatous inflammation in the region of the cavernous sinus.1
Neurologic diseases with dysimmune pathogenesis may be influenced by pregnancy. Progesterone affects maternal immune responses during pregnancy through modulation of Th1/Th2 balance.2 In the normal menstrual cycle, progesterone secretion increases after ovulation and remains high until the end of the advanced luteal phase. In the absence of implantation, progesterone levels decline, whereas in a fertile cycle there is continued and accelerated progesterone secretion. Clomiphene citrate is a follicular stimulant that induces ovarian response similar to that in natural cycles and is commonly used to treat ovulation problems.
We report a woman with two episodes of THS, the first triggered by clomiphene treatment and the second by progesterone treatment during pregnancy.
Case report.
A 32-year-old …
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