Tolosa-Hunt syndrome (THS) is a rare condition characterized by episodic, painful ophthalmoplegia secondary to idiopathic inflammation of the cavernous sinus, orbital apex, or superior orbital fissure, resulting in paralysis of the third, fourth, and/or sixth cranial nerves. The incidence of THS in the United States is one case per million people annually, with a mean onset of 38-41 +/- 14-16 years. Only 18 pediatric cases have been reported in the literature and there remains controversy regarding diagnostic approach and treatment strategies in children. We aim to offer an additional successful therapeutic approach.