Multiple cranial nerve palsies associated with type 2 diabetes mellitus.
Although isolated cranial nerve palsies are common in patients with diabetes mellitus, multiple simultaneous cranial neuropathies are rare. We report a 48-year-old man, a known case of diabetes mellitus, who presented with facial palsy, foot drop and painful ophthalmoplegia of the left eye. The initial differential diagnosis included diabetic polyneuropathy, septic cavernous sinus thrombosis, mucormycosis and the Tolosa Hunt syndrome. Magnetic resonance (MR) imaging findings were consistent with those of the Tolosa Hunt syndrome. The patient had a remarkable complete resolution of his ophthalmoplegia after four weeks of steroid treatment, with repeat MR imaging showing resolution of the initial changes.
Singh
N P
NP
Nephrology Division, Maulana Azad Medical College, New Delhi 110002, India.
Garg
S
S
Kumar
S
S
Gulati
S
S
D015897:Comorbidity; D003391:Cranial Nerves / Q000503:physiopathology*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D003929:Diabetic Neuropathies; D003937:Diagnosis, Differential; D005158:Facial Paralysis / Q000188:drug therapy / Q000209:etiology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use; D008875:Middle Aged; D015840:Oculomotor Nerve Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D009886:Ophthalmoplegia / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*
D008775:Methylprednisolone