Unveiling the Hidden Culprit: Isolated Abducens Nerve Palsy as a Result of Uncontrolled Diabetes Mellitus

Abstract

Background: Diabetes Mellitus is a chronic metabolic disorder characterized by persistent hyperglycemia and multifaceted systemic complications. Neurological manifestations of diabetes often involve cranial nerves, with isolated Abducens Nerve Palsy being a rare initial presentation.

Objective: This case report aims to highlight the atypical presentation of uncontrolled diabetes mellitus as an isolated Abducens Nerve Palsy and emphasizes the importance of early recognition and management to prevent further complications.

Case Description: We present a case of a 48-year-old male who presented with sudden-onset horizontal diplopia and restricted lateral eye movement in the right eye. Neurological examination revealed isolated Abducens Nerve Palsy without any other cranial nerve involvement. Blood glucose levels were significantly elevated, confirming uncontrolled diabetes mellitus. Further evaluation revealed no other underlying etiology for the nerve palsy. The patient was promptly initiated on insulin therapy and managed for his diabetes.

Conclusion: Isolated Abducens Nerve Palsy can be a rare but significant manifestation of uncontrolled diabetes mellitus. Clinicians should consider diabetes as a potential cause when evaluating patients with cranial nerve palsies, even when other neurological symptoms are absent. Early diagnosis and management of diabetes are crucial to prevent further complications and improve the patient's overall prognosis. This case underscores the importance of interdisciplinary collaboration between ophthalmologists, neurologists, and endocrinologists in managing such atypical presentations of diabetes mellitus.