ECE2022 Eposter Presentations Diabetes, Obesity, Metabolism and Nutrition (318 abstracts)
Institut National de Nutrition de Tunis, Service A, Tunis, Tunisia
Introduction: Diabetes mellitus is the leading cause of neuropathy worldwide. Non-retinal diabetic complications including oculomotor damage represent 1 to 3% of ocular manifestations of diabetes. The affected oculomotor nerves are essentially the external oculomotor nerve (VI), the common oculomotor nerve (III), and more rarely, the pathetic nerve (IV).
Observation: We report the case of a patient referred to our department for additional management of recently discovered diabetes. This is a 44-year-old patient with a history of Buergers disease with amputation of both right toes. The clinical examination showed binocular diplopia with left horizontal nystagmus and damage to the external oculomotor nerve VI on the left. As part of the exploration of this diplopia, a CT scanner and an angioscanner were performed. They were normal and showed no signs of an ischemic stroke. A cerebral MRI and a lumbar puncture were strictly normal. On biology, we found a fasting blood sugar at 7 mmol/l and a glycated hemoglobin at 8.9%. The patient started diet and metformin. The evolution was marked by the progressive remission of diplopia after glycemic control after six weeks.
Conclusions: Our observation illustrates the interest of screening for diabetes in the face of damage to the oculomotor nerves. The evolution is favorable spontaneously after few weeks, but the recurrence on the same side or on the contralateral side is possible.