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Multiple cranial nerve palsies associated with type 2 diabetes mellitus
1Nephrology Division, Maulana Azad Medical College, New Delhi 110002, India.
Singapore Medical Journal
|July 26, 2006
Summary
Multiple simultaneous cranial neuropathies are rare in diabetes mellitus patients. This case highlights Tolosa Hunt syndrome presenting with facial palsy and ophthalmoplegia, successfully treated with steroids.
Area of Science:
- Neurology
- Endocrinology
Background:
- Diabetes mellitus commonly causes isolated cranial nerve palsies.
- Multiple simultaneous cranial neuropathies are an uncommon presentation in diabetic patients.
Observation:
- A 48-year-old male with diabetes presented with facial palsy, foot drop, and left painful ophthalmoplegia.
- Differential diagnoses included diabetic polyneuropathy, septic cavernous sinus thrombosis, mucormycosis, and Tolosa Hunt syndrome.
Findings:
- Magnetic resonance (MR) imaging indicated Tolosa Hunt syndrome.
- The patient experienced complete resolution of ophthalmoplegia after four weeks of steroid therapy.
- Repeat MR imaging confirmed the resolution of initial findings.
Implications:
- This case expands the understanding of Tolosa Hunt syndrome presentations.
- Early diagnosis and steroid treatment can lead to favorable outcomes in complex cranial neuropathies.
- Highlights the importance of considering Tolosa Hunt syndrome in diabetic patients with multiple cranial nerve palsies.
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