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类固醇与维生素疗法对改善糖尿病性颅神经麻痹患者眼球运动的有效性:一项对比研究。

The Effectiveness of Steroid Versus Vitamin Therapy in the Improvement of Extraocular Movements in Patients With Diabetic Cranial Nerve Palsy: A Comparative Study.

作者信息

N Inchara, Shyam Kumar Smitha

机构信息

Ophthalmology, Sri Devaraj Urs Academy of Higher Education and Research, Kolar, IND.

Ophthalmology, Laxmi Eye Institute, Mumbai, IND.

出版信息

Cureus. 2024 Dec 13;16(12):e75656. doi: 10.7759/cureus.75656. eCollection 2024 Dec.

Abstract

BACKGROUND

Diabetic mononeuropathies, which are focal neuropathies, are less common than peripheral neuropathy in diabetes. They are frequently underreported or misdiagnosed due to mild or unnoticed cases. Early detection and treatment are crucial to prevent worsening nerve damage and complications.

OBJECTIVES

This study aims to compare the effectiveness of conventional treatment with vitamin therapy for improving these neuropathies.

METHODS

Fifty cases of diabetic ocular nerve palsy were stratified into two groups, 25 in each. Group A received steroids, while group B received vitamin B12 injections. Ocular movements were assessed before and after treatment initiation at 3, 6, and 10 days using the Kestenbaum limbus test. Inferential statistics were done using the chi-square test and the student t-test.

RESULTS

The average age of the participants in the study was 60.5 ± 6.3 years. Thirty-eight patients had sixth nerve palsy, and 12 patients had associated third nerve palsy. Thirty-eight subjects had poorly controlled diabetes. The mean enhancement in movements was 0.75 ± 0.3 in group A and 1.04 ± 0.5 in group B, with a p value of 0.026, demonstrating the statistically significant difference between both groups.

CONCLUSION

This study infers that the ocular movements were significantly improved with vitamin therapy. Treating diabetic neuropathy solely with vitamin supplementation indirectly addresses nutritional deficiencies, potentially accelerating diabetes-related complications and enhancing quality of life.

摘要

背景

糖尿病性单神经病变属于局灶性神经病变,在糖尿病中比周围神经病变少见。由于症状轻微或未被注意到,它们经常未得到充分报告或被误诊。早期发现和治疗对于预防神经损伤恶化和并发症至关重要。

目的

本研究旨在比较传统治疗与维生素疗法改善这些神经病变的效果。

方法

50例糖尿病性动眼神经麻痹患者被分为两组,每组25例。A组接受类固醇治疗,而B组接受维生素B12注射。在治疗开始前以及治疗后第3天、6天和10天使用凯斯滕鲍姆角膜缘试验评估眼球运动。使用卡方检验和学生t检验进行推断性统计。

结果

研究参与者的平均年龄为60.5±6.3岁。38例患者为第六神经麻痹,12例患者伴有第三神经麻痹。38名受试者的糖尿病控制不佳。A组运动改善的平均值为0.75±0.3,B组为1.04±0.5,p值为0.026,表明两组之间存在统计学上的显著差异。

结论

本研究推断维生素疗法可显著改善眼球运动。仅用维生素补充剂治疗糖尿病性神经病变可间接解决营养缺乏问题,可能加速与糖尿病相关的并发症并提高生活质量。

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本文引用的文献

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The aetiologies of the unilateral oculomotor nerve palsy: a review of the literature.单侧动眼神经麻痹的病因:文献综述
Somatosens Mot Res. 2018 Sep-Dec;35(3-4):229-239. doi: 10.1080/08990220.2018.1547697. Epub 2018 Dec 28.
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Entrapment neuropathies in diabetes mellitus.糖尿病性周围神经卡压综合征
World J Diabetes. 2016 Sep 15;7(17):342-53. doi: 10.4239/wjd.v7.i17.342.
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Ocular complications of diabetes mellitus.糖尿病的眼部并发症。
World J Diabetes. 2015 Feb 15;6(1):92-108. doi: 10.4239/wjd.v6.i1.92.

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