Noor Amna, Hafeez Amina, Safdar Noman, Nisar Mah Rukh, Bashir Qasim
Neurology, Services Hospital Lahore, Lahore, PAK.
Anesthesia, Services Hospital Lahore, Lahore, PAK.
Cureus. 2024 Sep 23;16(9):e70057. doi: 10.7759/cureus.70057. eCollection 2024 Sep.
A 60-year-old man with a history of diabetes mellitus and hypertension presented with diplopia and vertigo for two days. These symptoms had a gradual onset, were progressive, and were associated with a headache that had been present for 15 days. His blood sugar level was 376 mg/dl. His convergence and ability to adduct when looking laterally were affected bilaterally. Additionally, he presented with right exotropia on primary gaze and no ptosis. Brain imaging was normal. Following the rest of the work-up, diabetes mellitus was independently established as the cause of bilateral internuclear ophthalmoplegia in this patient. High blood sugar affects the brain at the molecular level by causing vascular damage, oxidative stress, and decreasing neuroplasticity.
一名有糖尿病和高血压病史的60岁男性，出现复视和眩晕两天。这些症状起病缓慢，呈进行性，且伴有持续15天的头痛。他的血糖水平为376毫克/分升。他双眼的集合以及向外侧注视时内收的能力均受到影响。此外，他在第一眼位时表现为右眼外斜视，无眼睑下垂。脑部影像学检查正常。经过其余的检查后，糖尿病被独立确定为本例患者双侧核间性眼肌麻痹的病因。高血糖通过引起血管损伤、氧化应激和降低神经可塑性，在分子水平上影响大脑。
