Tolosa hunt syndrome is rather a rare disease exact cause not known may be autoimmune it is characterised by unilateral periorbital pain hemicrania and diplopia On examination we find exophthalmos ophthalmoplegia involvement of 3rd 5th and 6th cranial nerves  sensory involvement of 1st and 2nd branch of 5th pupillary dysfunction Due to sympathetic dysfunction, there is non-inflammatory involvement of cavernous sinus and superior orbital fissure and if the information goes beyond CN sinus and involves optic nerve blindness can occur so the treatment of this condition is very urgent iv corticosteroids. It occurs equally in male and female rare in 1st and 2nd decade of life  investigations include  blood for ESR HIV ANA MRI scan Share your views.