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Transient Oculomotor Nerve PalsyAssociation With Thiazide-Induced Glucose Intolerance
Neil R. Miller, MD;
Howard Moses, MD
JAMA. 1978;240(17):1887-1888.
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| Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings. |
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ISOLATED oculomotor nerve palsy frequently occurs in patients with diabetes mellitus. Most patients affected are aged 50 to 70 years and have mild adult-onset diabetes that is often under control at the time the palsy begins. The onset of diabetic oculomotor nerve palsy is usually sudden and may be associated with considerable homolateral ocular, retrobulbar, or cephalic pain. The palsy generally persists for several months before resolving spontaneously. In most instances, the pupil remains normal; however, when the pupil is paralyzed, the major differential diagnosis is between an intracranial aneurysm and diabetes.1 The sudden onset of a painful, complete oculomotor nerve palsy developed in a patient while he was taking chlorothiazide. The patient's workup showed an elevated fasting blood glucose level and abnormal findings of a glucose tolerance test. After he discontinued therapy with the diuretic, the blood glucose abnormalities disappeared, and the oculomotor nerve palsy resolved.
Report of
. . . [Full Text PDF of this Article]
Author Affiliations
From the Neuro-ophthalmology Unit, The Wilmer Ophthalmological Institute (Dr Miller), and Department of Neurology, The Johns Hopkins Hospital (Dr Moses), Baltimore.
Footnotes
Reprint requests to the Neuro-ophthalmology Unit, The Wilmer Ophthalmological Institute, 601 N Wolfe St, Baltimore, MD 21205 (Dr Miller).
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