TY - JOUR
AR - CRSS-2020-1-107
TI - Anxiety Disorder and Alternating Bilateral Ptosis as the First Symptoms of Diabetes: A Case Report
AU - Mei-lan , Su
AU - Ming-hong , Zhang
AU - Song, Wang
AU - Zhong-Hui , Zou
AU - Zu-bin , Yin
JO - Case Reports and Series in Surgery
PY - 2020
DA - Thu 30, Apr 2020
SN - 2733-2241
DO - http://dx.doi.org/10.31487/j.CRSS.2020.01.07
UR - https://www.sciencerepository.org/anxiety-disorder-and-alternating-bilateral_CRSS-2020-1-107 
KW - Diabetes, oculomotor nerve palsy, upper eyelid ptosis, anxiety disorder
AB - Introduction: Long-term diabetes may cause oculomotor nerve palsy and anxiety disorder. Diabetic
oculomotor nerve palsy is usually accompanied by diplopia, ptosis and eye movement disorders. The
oculomotor nerve is often separated into superior and inferior divisions; diabetic third cranial nerve palsy
may affect either division in isolation. However, anxiety disorder and alternating bilateral ptosis as the first
symptoms of diabetes are extremely rare.
Case Presentation: This case report describes a 63-year-old female patient who was admitted to the hospital
for anxiety disorder with bilateral alternating ptosis. The patient had no diplopia or other new focal
neurological symptoms. A neurological examination revealed left upper eyelid ptosis; other findings were
negative. Except for hyperglycemia (13.96 mmol/L) and glycated hemoglobin (7.9%), laboratory tests
showed no other abnormalities. The patient eventually recovered in a short time after a comprehensive
treatment, including effective blood glucose control, microcirculation improvement and anxiety
management.
Conclusion: The upper eyelid droop caused by long-term diabetes may result in anxiety disorder. A
comprehensive treatment may be considered for the patients admitted to the hospital for diabetes and its
vascular neuropathy.