PERIPHERAL neuropathy in patients with diabetes mellitus is not uncommon, and several reviews of the subject have appeared in recent years.1 The mechanism of production of the neuritis has not been definitely established, but it appears to bear some relation to inadequate regulation, since it is reputed to be less frequent in patients in whom the diabetes has been continuously and carefully controlled. The onset is usually characterized by the gradual development of paresthesias and motor weakness; however, these symptoms may have a precipitous onset in the presence of acidosis or of a complicating acute infection.1b The lower extremities are commonly more severely affected than are the upper ones, and the neurologic findings in general are those of a mixed polyneuropathy involving the motor and sensory nerves.
Paralysis of the cranial nerves in diabetes was first described by Ogle2 in 1866. Since then, numerous case reports have
DANIEL L. LARSON, J. HOWLAND AUCHINCLOSS. MULTIPLE SYMMETRIC BILATERAL CRANIAL NERVE PALSIES IN PATIENTS WITH UNREGULATED DIABETES MELLITUSReport of Three Cases. Arch Intern Med (Chic). 1950;85(2):265–271. doi:10.1001/archinte.1950.00230080069003