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Ocular Motor Mononeuropathies in Diabetes Mellitus: A Brief Review
Dimitrios Pantazopoulos1, Evanthia Gouveri1, Dimitrios Papazoglou1
1Diabetes Centre-Diabetic Foot Clinic, Second Department of Internal Medicine, Democritus University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, Greece.
Abstract:
Ocular motor mononeuropathies affect cranial nerves III, IV and VI and are more frequent in diabetes mellitus, with oculomotor nerve involvement being predominant. This narrative brief review discusses the clinical manifestations, diagnosis and management of ocular motor mononeuropathies in subjects with diabetes. Clinical manifestations often include ptosis, diplopia, and periorbital pain. Pupillary sparing is a characteristic of third nerve palsy. Differential diagnosis may be challenging due to overlapping symptoms with nerve palsies of other aetiologies. Treatment includes optimised glycaemic control and management of vascular risk factors. Neuroprotective agents, mainly alpha-lipoic acid and botulinum toxin A have been occasionally used, as well. Spontaneous recovery is seen in many cases.
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