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

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.