Tic douloureux and diabetes mellitus
John S. Collis, M.D.
Department of Neurologic Surgery
Thomas W. Wallace, M.D.
Department of Neurology
THE facts that tic douloureux is an extremely painful disorder and that diabetes mellitus is frequently associated with pain at varied sites, led us to explore a possible association between the two disease entities. Accordingly, 30 patients with tic douloureux, whose status in regard to possible diabetes mellitus was not known, were selected for the study.
All 30 patients had typical idiopathic tic douloureux with pathognomonic pain. In no patient were there significant abnormal neurologic signs.
All of the patients were tested for glucose tolerance. The glucose tolerance tests consisted of blood sugar determinations both one hour and two hours after a 100-g glucose meal. The upper limits for the one-hour and two-hour blood sugar values were 160 mg and 105 mg per 100 ml, respectively. Of the 30 patients, 10 had abnormal values in the diabetic range. The case data are summarized in Table 1.
Many pathologic conditions have been associated with tic douloureux. These include multiple sclerosis, brain tumors, and vascular anomalies. Likewise, many abnormal conditions have been associated with diabetes mellitus.
However, published reports have not mentioned that diabetes mellitus was associated with tic douloureux.1 Though the number of patients in our series is small, the proportionately large number of patients with abnormal results of glucose tolerance tests, in the diabetic range, we believe is significant.
Possible sources of error were explored before we drew conclusions. For example, a period of starvation can produce abnormally high blood sugar values.2 It is certainly well known that . . .