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Diabetic third nerve palsy; Pupil-sparing third cranial nerve palsy
Cranial mononeuropathy III - diabetic type -- is a mononeuropathy. This means that only one nerve is damaged. The condition affects the third cranial (oculomotor) nerve. This is one of the cranial nerves that control eye movement.
This type of damage may occur along with diabetic peripheral neuropathy. Cranial mononeuropathy III is the most common cranial nerve disorder in people with diabetes. It is due to damage to the small blood vessels that feed the nerve.
Other causes may include:
Symptoms may include:
An examination of the eyes will determine whether only the third nerve is affected or if other nerves have also been damaged. Signs may include:
Your health care provider will do a complete examination to determine the possible effect on other parts of the nervous system. Depending on the suspected cause, you may need:
You may need to be referred to a doctor who specializes in vision problems related to the nerves in the eye (neuro-ophthalmologist).
There is no specific treatment to correct the nerve injury.
Treatments may include:
Some people may recover without treatment.
Many patients get better over 3 to 6 months. Some persons have permanent eye muscle weakness.
Call your health care provider if you have double vision and it does not go away in a few minutes, especially if you also have eyelid drooping.
Controlling your blood sugar level may reduce the risk of developing this disorder.
Rucker JC. Cranial neuropathies. In: Daroff RB, Fenichel GM, Jankovic J, Mazziotta JC, eds. Bradley's Neurology in Clinical Practice. 6th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 70.