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Acute Focal Neurological Events in Diabetes Mellitus

Purpose: To clinically profile acute focal neurological events in diabetes (excluding cerebrovascular accidents). Patients and Methods: Population - 511 consecutive diabetics who came to the Centre in a 12 month period. Focal neurological event - of sudden onset, lasting 24 hours or more. Results: Twelve out of 511 patients (2.35%) had 14 acute focal neurological events. Eight presented with the event (66.7%), whereas four had one in the past (33.3%). The commonest involvement was of the sixth cranial nerve (4/14; 28.6%), followed by seventh cranial nerve (3/14; 21.4%), two each (2/14; 14.3%) of third cranial nerve palsy, axillary nerve involvement and diabetic amyotrophy, and one (1/14; 7.1 %) of 4th cranial nerve involvement. Conclusion: Twelve patients (2.35%) among 511 consecutive diabetics had acute focal neurological events. Neurological involvement in diabetes is generally silent, progressive and irreversible. Yet there is a small subset where neural deficit is swift in onset and dramatic in its presentation. Unlike the insidious variety, neural loss in the acute form is usually transient. Apart from clinical interest, these acute events provide in a telescoped time span, situations where pathological, functional and morphological studies can answer some of the fundamental issues of diabetic neuropathy. The purpose of this study is to clinically profile acute focal neurological events (excluding cerebrovascular accident) in diabetics who presented at our Centre.