Advance Search

Prevalence of ocular motor nerve palsy among diabetic patients in Erbil city, Iraq

Hiba Kadhim Ahmed
Ministry of Health, Directorate of Health, Hawler Teaching Hospital, Erbil, Iraq.
Eman Hussein Alwan
Department of General Surgery, College of Medicine, Hawler Medical University, Erbil, Iraq.
Keywords:
Copyright and Licensing:

Copyright (c) 2024 Hiba Kadhim Ahmed, Eman Hussein Alwan (Author)

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

Share:
Crossref
Scopus
Google Scholar
Europe PMC

Abstract

Background and objective: The burden of morbidity and mortality caused by the complications of acute and chronic hyperglycemia is rising along with the prevalence of diabetes mellitus in the world. About 50% of diabetic patients will eventually develop neuropathy. In particular, the abducens, oculomotor, and trochlear nerves, which supply the extraocular muscles, are affected by the most common diabetic cranial mononeuropathies. This study is to determine the prevalence, risk factors, and main treatment options for ocular motor nerve palsy in diabetes individuals.

Methods: During the period from 1st of August 2021 to 31st of March 2022, a cross-sectional study was conducted in the Ophthalmology Department/ Rizgary Teaching Hospital and Erbil Teaching Hospital. A convenient sample of 500 patients who were diagnosed with diabetes was enrolled in the current study.

Results: Out of the 500 patients, 6 (1.2%) had oculomotor nerve palsy, of them, 2 (33.3%) had ptosis, 4 (66.6%) had diplopia, and 2 (33.3%) had pain. Trochlear nerve palsy was diagnosed in 2 (0.4%) of the patients. Of them, 2 (100%) had diplopia. Only one patient was diagnosed with abducent nerve palsy and presented with diplopia. Diabetic retinopathy was diagnosed in 31.3%.

Conclusion: The prevalence of ocular motor nerve palsy was low among diabetic patients in the current study but it was higher than recorded in other studies. Many factors including occupation, smoking, alcohol, hypertension, hyperlipidemia, cerebrovascular disease, Aspirin use, duration of diabetes, and presence of diabetic retinopathy can affect the prevalence of ocular motor nerve palsy.

PDF
PDF

Metrics

Metrics Loading ...

References

  1. Golbidi S, Alireza Ebadi S, Laher I. Antioxidants in the treatment of diabetes. Curr Diabetes Rev 2011; 7(2):106–25. https://doi.org/10.2174/157339911794940729
  2. Ralston SH, Penman ID, Strachan MWJ, Hobson R. Davidson's Principles and Practice of Medicine E-Book. 23rded. USA:Elsevier Health Sciences; 2018.
  3. Forbes JM, Cooper ME. Mechanisms of diabetic complications. Physiol Rev 2013; 93(1):137–88. https://doi.org/10.1152/physrev.00045.2011
  4. Chou P-Y, Wu K-H, Huang P. Ptosis as the only manifestation of diabetic superior division oculomotor nerve palsy: A case report. Medicine 2017; 96(46):e8739. https://doi.org/10.1097/MD.0000000000008739
  5. Li B, Sursal T, Bowers C, Cole C, Gandhi C, Schmidt M, et al. Chameleons, red herrings, and false localizing signs in neurocritical care. Br J Neurosurg 2022; 36(3):298–306. https://doi.org/10.1080/02688697.2020.1820945
  6. Ahmad K, Wright M, Lueck CJ. Ptosis. Pract Neurol 2011; 11(6):332–40. https://doi.org/10.1136/practneurol-2011-000026
  7. Horn AK, Leigh RJ. The anatomy and physiology of the ocular motor system. Handb Clin Neurol 2011; 102:21–69. https://doi.org/10.1016/B978-0-444-52903-9.00008-X
  8. Kung NH, Van Stavern GP. Isolated Ocular Motor Nerve Palsies. Semin Neurol 2015; 35(5):539–48. https://doi.org/10.1055/s-0035-1563568
  9. Hofer JE, Scavone BM. Cranial nerve VI palsy after dural-arachnoid puncture. Anesth Analg 2015; 120(3):644–6. https://doi.org/10.1213/ane.0000000000000587
  10. Elder C, Hainline C, Galetta SL, Balcer LJ, Rucker JC. Isolated Abducens Nerve Palsy: Update on Evaluation and Diagnosis. Curr Neurol Neurosci Rep 2016; 16(8):69. https://doi.org/10.1007/s11910-016-0671-4
  11. Murchison AP, Bilyk JR, Savino PJ. Traumatic Cranial Neuropathies. Smith and Nesi’s Ophthalmic Plastic and Reconstructive Surgery. Switzerland: Springer; 2021. P. 145–78.
  12. Al Kahtani ES, Khandekar R, Al-Rubeaan K, Youssef AM, Ibrahim HM, Al-Sharqawi AH. Assessment of the prevalence and risk factors of ophthalmoplegia among diabetic patients in a large national diabetes registry cohort. BMC Ophthalmol 2016; 16(1):1–8. https://doi.org/10.1186/s12886-016-0272-7
  13. Greco D, Gambina F, Pisciotta M, Abrignani M, Maggio F. Clinical characteristics and associated comorbidities in diabetic patients with cranial nerve palsies. J Endocrinol Invest 2012; 35(2):146–9. https://doi.org/10.3275/7574
  14. Mansour AA. Chronic complications of diabetes in Iraq: experience from southern Iraq. Clinical medicine. Endocrinology and diabetes 2009; 2:CMED.S3657. https://doi.org/10.4137/CMED.S3657
  15. ALTINTAS AGK. Trochlear nerve palsy: A review of etiology, incidence, diagnostic methods, and treatment alternatives. Arch Neurol & Neurosci 2020; 7(4). http://dx.doi.org/10.33552/ANN.2020.07.000666
  16. Lajmi H, Hmaied W, Ben Jalel W, Chelly Z, Ben Yakhlef A, Ben Zineb F, et al. Oculomotor palsy in diabetics. J Fr Ophtalmol 2018; 41(1):45–9. https://doi.org/10.1016/j.jfo.2017.06.010
  17. Seidu S, Kunutsor SK, Sesso HD, Gaziano JM, Buring JE, Roncaglioni MC, et al. Aspirin has potential benefits for primary prevention of cardiovascular outcomes in diabetes: updated literature-based and individual participant data meta-analyses of randomized controlled trials. Cardiovasc Diabetol 2019; 18(1):70. https://doi.org/10.1186/s12933-019-0875-4
  18. Park UC, Kim SJ, Hwang JM, Yu YS. Clinical features and natural history of acquired third, fourth, and sixth cranial nerve palsy. Eye 2008; 22(5):691–6. https://doi.org/10.1038/sj.eye.6702720
How to Cite
Kadhim Ahmed, H., & Hussein Alwan, E. . (2024). Prevalence of ocular motor nerve palsy among diabetic patients in Erbil city, Iraq . Zanco Journal of Medical Sciences (Zanco J Med Sci), 28(3), 445–454. https://doi.org/10.15218/zjms.2024.44

Send mail to Author

Send Cancel