Clinical course following diabetic ocular palsy

Abstract

Summary Eleven patients who had a diabetic ocular palsy were reviewed. Clinical evidence of microangiopathy or atherosclerosis was infrequent, thus such a palsy does not presage subsequent diabetic complications nor do these observations support the suggestion that diabetic ocular palsies are caused by vascular disease.

Painful ophthalmoplegia with normal cranial imaging

“…Patients with OM recovered faster than patients with THS and ocular diabetic neuropathy, consistent with previously reported results [ 7 , 10 , 18 , 19 , 25 , 26 ]. The average recovery time of OM is approximately 3 weeks, whereas that of THS is approximately 2 months and ocular diabetic neuropathy is 3–4 months [ 7 , 9 , 10 , 18 , 19 ].…”

“…Pupil sparing was not only common in patients with ocular diabetic neuropathy, but was also common in patients with THS and OM. It is widely accepted that pupillary dysfunction is suggestive of aneurysmal or neoplastic compressive lesions [ 27 , 28 ], and it is not common in diabetic ophthalmoplegia [ 25 , 26 , 29 ]. Only 14–18% of patients with diabetic ophthalmoplegia develop pupillary dysfunction [ 29 ].…”

Painful ophthalmoplegia with normal cranial imaging

“…Patients with OM recovered faster than patients with THS and ocular diabetic neuropathy, consistent with previously reported results [ 7 , 10 , 18 , 19 , 25 , 26 ]. The average recovery time of OM is approximately 3 weeks, whereas that of THS is approximately 2 months and ocular diabetic neuropathy is 3–4 months [ 7 , 9 , 10 , 18 , 19 ].…”

“…Pupil sparing was not only common in patients with ocular diabetic neuropathy, but was also common in patients with THS and OM. It is widely accepted that pupillary dysfunction is suggestive of aneurysmal or neoplastic compressive lesions [ 27 , 28 ], and it is not common in diabetic ophthalmoplegia [ 25 , 26 , 29 ]. Only 14–18% of patients with diabetic ophthalmoplegia develop pupillary dysfunction [ 29 ].…”

Diabetic Polyneuropathy

“…The patient presents with pain in the orbit or sometimes with a frontal headache [ 40,41 ] . There is typically ptosis and ophthalmoplegia, although the pupil is usually spared [ 42,43 ] . Recovery occurs usually over 6 months.…”

Diabetic neuropathy: achieving best practice

“…There are no controlled trials, although many authorities favour the use of insulin particularly in poorly controlled type 2 diabetic patients. 34 Some patients benefit from physiotherapy that involves extension exercises aimed at strengthening the quadriceps. The management of pain in proximal motor neuropathy is similar to that of acute distal symmetrical neuropathies or DSP (see below).…”

“…35,36 There is typically ptosis and ophthalmoplegia, although the pupil is usually spared. 34,37 Recovery occurs usually over three months. The clinical onset and time-scale for recovery, and the focal nature of the lesions on post-mortem studies suggested an ischaemic aetiology.…”

Painful ophthalmoplegia with normal cranial imaging

“…Patients with OM recovered faster than patients with THS and ocular diabetic neuropathy, consistent with previously reported results [ 7 , 10 , 18 , 19 , 25 , 26 ]. The average recovery time of OM is approximately 3 weeks, whereas that of THS is approximately 2 months and ocular diabetic neuropathy is 3–4 months [ 7 , 9 , 10 , 18 , 19 ].…”

“…Pupil sparing was not only common in patients with ocular diabetic neuropathy, but was also common in patients with THS and OM. It is widely accepted that pupillary dysfunction is suggestive of aneurysmal or neoplastic compressive lesions [ 27 , 28 ], and it is not common in diabetic ophthalmoplegia [ 25 , 26 , 29 ]. Only 14–18% of patients with diabetic ophthalmoplegia develop pupillary dysfunction [ 29 ].…”

Diabetic Polyneuropathy

“…The patient presents with pain in the orbit or sometimes with a frontal headache [ 40,41 ] . There is typically ptosis and ophthalmoplegia, although the pupil is usually spared [ 42,43 ] . Recovery occurs usually over 6 months.…”

Diabetic neuropathy: achieving best practice

“…There are no controlled trials, although many authorities favour the use of insulin particularly in poorly controlled type 2 diabetic patients. 34 Some patients benefit from physiotherapy that involves extension exercises aimed at strengthening the quadriceps. The management of pain in proximal motor neuropathy is similar to that of acute distal symmetrical neuropathies or DSP (see below).…”

“…35,36 There is typically ptosis and ophthalmoplegia, although the pupil is usually spared. 34,37 Recovery occurs usually over three months. The clinical onset and time-scale for recovery, and the focal nature of the lesions on post-mortem studies suggested an ischaemic aetiology.…”

Painful ophthalmoplegia with normal cranial imaging

“…Patients with OM recovered faster than patients with THS and ocular diabetic neuropathy, consistent with previously reported results [ 7 , 10 , 18 , 19 , 25 , 26 ]. The average recovery time of OM is approximately 3 weeks, whereas that of THS is approximately 2 months and ocular diabetic neuropathy is 3–4 months [ 7 , 9 , 10 , 18 , 19 ].…”

“…Pupil sparing was not only common in patients with ocular diabetic neuropathy, but was also common in patients with THS and OM. It is widely accepted that pupillary dysfunction is suggestive of aneurysmal or neoplastic compressive lesions [ 27 , 28 ], and it is not common in diabetic ophthalmoplegia [ 25 , 26 , 29 ]. Only 14–18% of patients with diabetic ophthalmoplegia develop pupillary dysfunction [ 29 ].…”

Diabetic Polyneuropathy

“…The patient presents with pain in the orbit or sometimes with a frontal headache [ 40,41 ] . There is typically ptosis and ophthalmoplegia, although the pupil is usually spared [ 42,43 ] . Recovery occurs usually over 6 months.…”

Diabetic neuropathy: achieving best practice

“…There are no controlled trials, although many authorities favour the use of insulin particularly in poorly controlled type 2 diabetic patients. 34 Some patients benefit from physiotherapy that involves extension exercises aimed at strengthening the quadriceps. The management of pain in proximal motor neuropathy is similar to that of acute distal symmetrical neuropathies or DSP (see below).…”

“…35,36 There is typically ptosis and ophthalmoplegia, although the pupil is usually spared. 34,37 Recovery occurs usually over three months. The clinical onset and time-scale for recovery, and the focal nature of the lesions on post-mortem studies suggested an ischaemic aetiology.…”