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Although isolated cranial nerve palsies are common in patients with diabetes mellitus, multiple simultaneous cranial neuropathies are rare. We report a 48-year-old man, a known case of diabetes mellitus, who presented with facial palsy, foot drop and painful ophthalmoplegia of the left eye. The initial differential diagnosis included diabetic polyneuropathy, septic cavernous sinus thrombosis, mucormycosis and the Tolosa Hunt Syndrome. Magnetic resonance (MR) imaging findings were consistent with those of the Tolosa Hunt Syndrome. The patient had remarkable complete resolution of his ophthalmoplegia after four weeks of steroid treatment, with repeat MRI imaging showing resolution of the initial changes. |
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cranial neuropathy cranial neuropathy,multiple diabetes mellitus diabetic ophthalmoplegia eye,pain in MRI,abnormal MRI,contrast enhanced ophthalmoplegia ophthalmoplegia,painful pain retro-orbital pain steroid therapy,CNS treatment and complications with Tolosa Hunt syndrome treatment of neurologic disorder
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