Bharathi Narasimhamurthy1 , Kamakshi Nagappa Moger2 , B. L. Sujatha Rathod3 , Subramanya Kota Giliyar4 , Ranjitha Chowkahally Sadananda5
BACKGROUND Diabetic cranial neuropathies usually involve cranial nerves III, IV and VI causing acute onset of ophthalmoplegia. These result from diabetes, hypertension, hyperlipidaemia and advanced age. The incidence of cranial nerve palsies in diabetic patients was significantly higher than in non-diabetic patients. We wanted to evaluate the recovery of cranial nerve palsies in relation to the duration and severity of diabetes mellitus and determine the factors associated with diabetes mellitus attributing to the cranial nerve palsies. METHODS 30 patients with diabetes mellitus were enrolled in the study. Detailed medical history was taken and ocular examination was carried out. Degree of ophthalmoplegia, residual muscle deviation, and ocular movements at each visit were recorded. Blood pressure, RBS, HbA1c and lipid profile were recorded. RESULTS Of the 30 patients, males contributed 53.3% and females contributed 46.7%. 67% patients had sixth cranial nerve palsy and 33% patients had third cranial nerve palsy showing that the most common affected nerve is abducens nerve. The mean duration of diabetes mellitus was 6.8 years, mean RBS level was 236 mg/dL and the mean HbA1c level was 8.3 gm%. Majority of the patients had association of hypertension which accounted for 40% of patients. CONCLUSIONS The most commonly affected cranial nerve in our study was abducens nerve. The most common association of diabetes mellitus noticed was hypertension. Majority of cases of ischemic ocular motor nerve palsies showed spontaneous recovery by 3 months with medical treatment and with good control of blood glucose level.
