J Korean Neurol Assoc.  2000 May;18(3):349-352.

A Case of Sequential Multiple Cranial Neuropathies in Diabetes Mellitus

• Kwak JH
• Park KJ
• Lee YH
• Hong JG
• Choi NC
• Kwon OY
• Lim BH

Abstract

Cranial mononeuropathies, manifesting particulary as opthalmoplegia or facial palsy, are common entities in the dia-betic population. However, sequential multiple cranial neuropathies due to diabetes are much less common. It is often associated with other conditions such as a brain tumor or head trauma. A 61-year-old diabetic man presented with ptosis, opthalmoplegia, and facial palsy which were manifestations of multiple cranial neuropathies involving the left 3rd, 4th, 6th, and 7th cranial nerves throughout five weeks. The pupils were not involved. The neurologic evaluation included a CSF study and a brain MRI with MRA. None of them produced any significant results. Blink reflexes revealed evidence of a left facial nerve lesion. The blood glucose was strictly controlled and steroid therapy was administered. The ptosis of the patientanjx left eyelid improved during treatment and he was discharged after 13 days. In a follow-up examination 3 months after onset, focal neurological deficits including opthalmoplegia and facial palsy on the left side were greatly improved and barely noticeable.

Keyword

Sequential multiple cranial neuropathies; Diabetes mellitus; Blink reflex

MeSH Terms

Blinking
Blood Glucose
Brain
Brain Neoplasms
Cranial Nerve Diseases*
Cranial Nerves
Craniocerebral Trauma
Diabetes Mellitus*
Eyelids
Facial Nerve
Facial Paralysis
Follow-Up Studies
Humans
Magnetic Resonance Imaging
Middle Aged
Mononeuropathies
Pupil
Blood Glucose