Clinical characteristics and associated comorbidities in diabetic patients with cranial nerve palsies.

Abstract

Cranial mononeuropathy is one of the not so common forms of diabetic neuropathy that often appears to be a serious problem from a diagnostic and therapeutic point of view. Objective of this study was to determine the incidence, the clinical characteristics, and risk factors associated with cranial nerve palsies among persons with diabetes. We have performed a retrospective study of all diabetic patients with cranial nerve palsies who were hospitalized in a metabolic department over a 12-yr period. During the period of the survey, a total of 8150 diabetic subjects were hospitalized and cranial nerve palsies were identified in 61 patients (0.75%). Isolated III nerve palsies accounted for the majority of patients (0.35%), with VII nerve palsies (0.21%) occurring more frequently than VI (0.15%) and multiple palsies (0.04%). Peripheral neuropathy was present in only 24% of patients. Patients with VII nerve palsies showed a tendency toward a lower coexistence of diabetic complications and cardiovascular risk factors than those with III and VI nerve palsies. Cranial nerve palsies are a not common problem among patients with diabetes; diagnosis of diabetic mononeuropathy should be considered even in the absence of peripheral neuropathy; the oculomotor nerve was most frequently affected in our case report. The coexistence of diabetic complications and cardiovascular risk factors was slightly lower in patients with VII nerve palsy: this fact is compatible with the hypotesis that this event is less closely related to diabetes and metabolic factors in its pathogenesis.