Causes of Painful Ophthalmoplegia - Differential Diagnosis
• Trauma
• Autoimmune:
1. Sarcoidosis
2. GPA
3. Eosinophilic granuloma
4. Tolosa-Hunt syndrome
5. Giant cell arteritis
• Infectious:
1. Bacterial: Treponema pallidum, contiguous sinusitis, mucocele, periostitis, abscess
2. Viral: Herpes zoster
3. Fungal: Mucormycosis, actinomycosis
4. Mycobacteria
• Vascular:
1. Carotid-cavernous fistula
2. Carotid-cavernous thrombosis
3. Aneurysms of the intracavernous carotid artery, posterior cerebral artery, or posterior communicating artery
4. Internal carotid artery dissection
• Neoplastic:
1. Intracranial tumors: pituitary adenoma, meningioma, and craniopharyngioma
2. Local metastases: nasopharyngeal tumor, squamous cell carcinoma
3. Other distant tumors: Lymphoma, Multiple myeloma, carcinomatous metastases
• Others: ophthalmoplegic migraine
• Image-negative:
1. Ocular diabetic neuropathy
2. Ophthalmoplegic migraine
3. "Benign" Tolosa-Hunt syndrome
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