Steroid-responsive painful ophthalmoplegia in childhood: sphenoid sinusitis presenting as Tolosa-Hunt syndrome.

A childhood case of painful ophthalmoplegia which responded well to steroids was described. Although the clinical features suggested Tolosa-Hunt syndrome (THS), serial magnetic resonance imagings (MRI) revealed ethmoid and sphenoid sinusitis in this 7-year-old boy. It was considered that multiple factors such as allergy, viral infection and swimming predisposed him to develop severe sinusitis and gave rise to his painful ophthalmoplegia.