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颅神经病变是糖尿病的常见合并症之一,约占糖尿病合并征0.4～7%;以动眼神经、外展神经为多见.现将我们诊治的糖尿病并眼肌麻痹14例报告如下.1 临床资料1.1 一般资料14例中.男11例.女3例、年龄41～79岁、平均60.5岁.既往有糖尿病史8例;病程1～4年5例.5～10年3例;此8例入院时仅1例血糖在正常范围,余7例高于正常.既往无糖尿病史6例.入院时3例血糖正常值.后经糖耐量试验确诊为糖尿病;3例血、尿糖均高于正常值.14例中既往同时并有高血压病9例,合并糖尿病周围神经炎2例.1.2 症状及体征:急性起病11例,亚急性起病3例,首次发病12例,复发2例.发病前1～5天头痛10例,均以前额及病侧眼眶痛为主.全部病人均以复视就诊,14例中动眼神经不完全麻痹11例,完全麻痹1例.单纯动眼神经麻痹8例,动眼神经合并外展神经麻痹3例.合并滑车神经麻痹1例.单纯外展神经、滑车神经麻痹各1例,上述各眼肌麻痹均限于一侧.14
Cranial neuropathy is one of the common complication of diabetes, accounting for about 0.4 to 7% of diabetic complications; to oculomotor nerve, abducens nerve is more common now we diagnosed diabetes and ophthalmoplegia in 14 cases reported as follows.1 Clinical data 1.1 General information 14 cases, 11 males and 3 females, aged 41 to 79 years old, average 60.5 years old in the past with diabetes mellitus history of 8 cases; course of 1 to 4 years in 5 cases 5 to 10 years in 3 cases; Only 8 cases were admitted to the hospital with only 1 case of normal blood glucose and 7 cases were higher than normal. There were 6 cases with no previous history of diabetes mellitus, 3 cases with normal blood glucose level at admission, 3 cases with diabetes diagnosed by glucose tolerance test, 3 cases with blood and urine sugar Higher than the normal value.Fourteen patients had previous hypertension with 9 cases, with diabetic peripheral neuropathy in 2 cases.2.2 Symptoms and signs: acute onset in 11 cases, subacute onset in 3 cases, the first onset in 12 cases, recurrence 2 cases of 1 to 5 days before onset of headache in 10 cases, both in the forehead and the orbital side of the orbital pain.All the patients were treated with diplopia, 14 cases of incomplete central nerve paralysis in 11 cases, complete paralysis in 1. Simple Oculomotor nerve paralysis in 8 cases, oculomotor nerve combined with abducens nerve paralysis in 3 cases .There were 1 cases of combined trochlear nerve paralysis.Only 1 case of abducensial nerve and trochlear nerve paralysis, Each of said side ophthalmoplegia are limited .14