Aspirin use and the prevention of acute ischemic cranial nerve palsy

PURPOSE: To assess the relationship of aspirin use and ischemic cranial ner ve palsies among patients with diabetes mellitus and hypertension, METHODS: This retrospective case-control study involved 100 patients with i schemic cranial nerve palsies in association with diabetes, hypertension, o r both (palsy cases) and 163 age-matched and sex-matched patients with diab etes, hypertension, or both but without ischemic cranial nerve palsies (non palsy control subjects). Comparisons were made with respect to duration of diabetes, dose and duration of aspirin use, dose and duration of tobacco us e, and presence of cardiac or cerebrovascular disease. RESULTS: There were 20 oculomotor, 33 trochlear, 37 abducens, and 10 facial nerve palsy cases. The median duration of diabetes was 6 years for cases a nd 7 years for control subjects. There were 34 cases (34%) who had used asp irin for a mean duration of 5.5 years before the onset of the cranial nerve palsy and 49 control subjects (30.1%) who had used aspirin for a mean dura tion of 4.3 years. There were no significant differences between cases and control subjects for duration of diabetes (P = .94); aspirin use (P = .51), duration (P = .50), and dosage (P = .89); tobacco use (P = .73) and consum ption (P = .45); and proportion of cardiac disease (P = .17). Cerebrovascul ar disease was significantly less common among palsy cases than nonpalsy co ntrol subjects (P < .001), There was no significant difference in the odds of a patient having cranial nerve palsy in the aspirin group compared with the nonaspirin group (odds ratio, 1.12; 95% confidence interval, 0.70-2.04) . CONCLUSION: Aspirin use was not associated with a reduced rate of ischemic third, fourth, sixth, and seventh nerve palsies among patients with diabete s mellitus and hypertension. Aspirin appears to be ineffective in preventin g ischemic third, fourth, sixth, and seventh cranial nerve palsies, Patient s with ischemic cranial nerve palsy have a significantly lower rate of stro kes and transient ischemic attacks than patients who have diabetes or hyper tension but who do not have a history of cranial nerve palsy. (C) 2000 by E lsevier Science Inc. All rights reserved.