Third Cranial Nerve Palsy Associated With Diabetes Melitus In An Acute Non-Hemorrhagic Stroke Patient: a Case Report
1 Neurology Departement, Faculty of Medicine, Public Health and Nursing, Gadjah Mada University, Yogyakarta, Indonesia
2 Wates Hospital, Kulon Progo, Yogyakarta, Indonesia
A 53 years old female with sudden complaints of slurred speech and unilateral face drop, the both eyes are difficult to open and weakness of the left limb. The patient had a history of diabetes melitus since five years ago with treatment are insulin and Glimepiride. The patient also had a history of hypertension since 1 years ago, but she did not treatment regularly. The physical examination result showed left hemiparese, Bilateral III nerve palsy, VII and XII right nerve palsy of Upper motor neuron. The head CT scan non contras showed Infarct medius hemisfer sinistra, cerebellum sinistra lobe and old infarct frontal sinistra lobe.
Non hemorrhagic stroke constitutes 88% of stroke cases. Ischemic occurs due to blockage or decreased cerebral blood flow. There are some risk factors of the stroke such as diabetes melitus and hypertension that causing microvascular disease. Bilateral third nerve palsy can occur in stroke if the presence of microvascular disorders. The results of previous research, third nerve palsy occured 41.7% (partial 25% and total 16.7%). the most causes of III, IV, VI nerve palsy as much as 58.3% were microvascular.