Diabetic oculomotor mononeuropathy: involvement of pupillomotor fibres with slow resolution

The third and sixth cranial nerves are most frequently affected in diabetic extraocular mononeuropathies. In diabetic oculomotor involvement the pupil is undisturbed. Of the 21 patients of diabetic oculomotor paralysis 4 patients (19 percent) had dilated unreactive pupil suggestive of pupillomotor involvement. No other cause could be attributed to oculomotor paralysis. These patients showed complete but slow resolution as compared to those without pupil involvement.