A Clinical Analysis of 36 Cases with Diabetic Cranial Neuropathy
Abstract Number: 2136-PO
Authors: DAI FANG, XINGWU RAN, WANG CHUN, TIEYUN ZHAO, NANWEI TONG, XIUJUN LI
Institutions: Chengdu, Sichuan, China
Results: Objective To investigate the clinical characteristics and explore the treatment and prognosis for diabetic cranial neuropathy (DCN). Methods: Thirty-six medical records of in-patients with DCN from December 1993 to July 2003 were studied. Results: 1 Among the 36 cases 14 were males and 22 females with an average age of 62.9±12.6 years; One was DM1 and 35 were DM2 with an average diabetic duration 7.6 ± 7.3 years. Eighteen cases had acoustic neuropathy, 9 oculomotor neuropathy, 5 optic neuropathy, 3 facial neuropathy and 1 abducent neuropathy. 2 All of the cases have one or multiple microvascular end-organ complications of diabetes such as retinopathy(44%), peripheral neuropathy(41%) and nephropathy(22%); moreover, there were 24 cases with hypertension, 13 with hyperuricemia, 10 with hyperlipidemia and 5 with coronary heart disease.3. Laboratory tests revealed average FBG 12.3 ± 4.04 mmol/L, BG2h 16.6 ± 4.93 mmol/L; HbA1c 8.63 ± 2.26%; serum TG 2.43 ± 2.23 mmol/L, TC 5.20 ± 1.50 mmol/L, LDL-C 2.11 ± 1.23 mmol/L, HDL-C 1.42 ± 0.37 mmol/L. 4 The patients were treated with intensive insulin therapy, the average FBG was 7.03 ± 2.04 mmol/L, BG2h was 9.44 ± 2.68mmol/L at the time of discharge. Also, nerve nutrient such as Methylcobalzmin, anticoagulant drugs such as low molecular weight heparin sodium and Cilostazol were administered. Traditional Chinese medicines such as Ligustrazine, Salvia Miltiorrhiza and traditional Acupuncture and Moxibustion were used to improve the local microcirculation. The symptoms and signs gradually improved over the next week and almost resolved after 3 weeks. Conclusions: DCN, characterized by the disorder of acoustic, oculomotor, optic or facial nerves etc, usually occurs in the long-term, poorly controlled diabetic patients. Treatment of DCN mainly involves intensively control of blood glucose, amelioration of local microcirculation and using nerve nutrient. In most of the patients, the short-term prognosis is good.