The disease, as a rule, begins precisely with severe pain in the area behind the eyeball, in the temporal, frontal, superciliary area. After a few days (usually no later than 14 days, less often at the same time), double vision in the eyes, limitation of mobility of the eyeball and strabismus on the side of pain are added. Approximately 1/4 of patients with all the nerves that pass through the upper orbital gap develop a complete impairment of movements of the eyeball in all leads.
More often there are “incomplete” forms of the Tolosa-Hunt syndrome, in which the branches of the oculomotor, trigeminal, optic nerves are involved in the pathological process in various combinations. In some patients exophthalmos and edema of the conjunctiva of the eyeball are observed. The average duration of pain is about two months. Also, in isolated cases, there may be an increase in body temperature to subfebrile values, nonspecific changes in the clinical analysis of blood.