A Case of Post-treatment Diabetic Neuropathy with Tonic Pupils.
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We report a 29-year-old man, a case of post-treatment diabetic neuropathy with tonic pupils. His diabetic control had been poor for 8 years and subsequent intensive therapy was introduced. Severe pain of the lower extremities, excessive sweating over the upper body, orthostatic hypotension and bilateral photophobia were observed. We identified tonic miotic responses after convergence, but no response to light in either pupil. Furthermore, we found segmental palsy, leading to a diagnosis of post-treatment neuropathy with tonic pupils. The instillation of 5% phenylephrine caused fine mydriasis in both eyes. It was suggested that his sympathetic nerves to the iris were in a hypersensitive state due to renervation. It was thought that denervation and renervation of autonomic nerves had caused post-treatment diabetic neuropathy. Therefore, we must at times be careful about pupillary alterations when acutely improving the hyperglycemia of poorly controlled diabetics.
- 一般社団法人 日本糖尿病学会の論文
一般社団法人 日本糖尿病学会 | 論文
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