微血管性病變引起之單側外展神經麻痺：新診斷糖尿病病例報告與文獻回顧

Unilateral Abducens Nerve Palsy Caused by Microvascular Disease in Newly Diagnosed Diabetes Mellitus: A Case Report and Literature Review

第六對腦神經又稱外展神經，負責控制眼球外展。單側外展神經麻痺常見於成人，臨床表現為急性水平複視，多由血管性缺血導致，尤其在糖尿病患者中更為常見。本文報告一例68歲女性，主訴持續性複視與體重減輕，神經學檢查發現左眼外直肌運動受限。進一步檢查發現有高血壓、高血糖與高血脂，經過排除其他可能的診斷後，推測為新診斷糖尿病合併左側外展神經麻痺。本文亦針對第一線醫師，提供關於單側外展神經麻痺的臨床評估流程、鑑別診斷與處置建議之簡要文獻回顧。

The sixth cranial nerve, also known as the abducens nerve, is responsible for abduction of the eye. Unilateral abducens nerve palsy is common in adults and typically presents with acute horizontal diplopia. The most frequent cause is often microvascular ischemia, particularly in patients with diabetes mellitus. We report the case of a 68-year-old woman who presented with persistent diplopia and unintentional weight loss. Neurological examination revealed limited movement of the lateral rectus muscle. Further evaluation identified hypertension, hyperglycemia, and hyperlipidemia. After other potential causes were excluded, the patient was diagnosed with left abducens nerve palsy associated with newly diagnosed diabetes mellitus. This article includes a brief literature review intended for frontline clinicians, summarizing the clinical approach, differential diagnosis, and management of unilateral abducens nerve palsy.