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August 1959

Paralyses of the Extraocular Muscles in Diabetes

Author Affiliations

New Bern, N. C.

AMA Arch Intern Med. 1959;104(2):318-322. doi:10.1001/archinte.1959.00270080144020

The neurological complications of diabetes have been extensively studied and recorded in recent years, especially peripheral diabetic neuropathy, characterized by loss of peripheral reflexes, hyperesthesia, paresthesias, nocturnal pain, and motor paralysis with muscular atrophy.1 More recently manifestations of disturbed autonomic nerve function with loss of sweating and pilomotor control, orthostatic hypotension, tachycardia, pupillary abnormality, gastrointestinal motor disturbances, impotence, atonic bladder, and other sphincter disturbances have been described and emphasized.2,3 Paralyses of the cranial nerves, though infrequent, have received less attention.

Three cases of paralyses of the ocular muscles seen in private practice within five years are reported. In the first case, the diabetic origin was not considered and the possibility of intracranial neoplasm or aneurysm was considered until the condition rapidly cleared. In the second case, the consultant rapidly recognized the presence of mild and as yet unrecognized diabetes. In the third case, diabetes had been poorly controlled