Acute bilateral basal ganglia lesions in diabetic uraemia: diffusion-weighted MRI

Lee, Eun Ja; Park, Jong Ho; Ihn, Yon Kwon; Kim, Young Joo; Lee, Seon Kyu; Park, Chan Sup

doi:10.1007/s00234-007-0299-9

Cited by 56 publications

(71 citation statements)

References 21 publications

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“…Our patient did not have hypotension, vasculitis or an active infection. Bilateral basal ganglia involvement may also occur in nonketotic hyperglycemia and it is observed as hyperdense lesions in cranial computed tomography (5). There was no significant hyperglycemia at the hospitalization of our patient and blood glucose levels were regulated during hospitalization with adjustment of insulin doses.…”

Section: Conclusıonsmentioning

confidence: 54%

See 1 more Smart Citation

Acute Chorea Characterized by Bilateral Basal Ganglia Lesions in a Patient with Diabetic Nephropathy

Doğan¹,

Kahvecioğlu²,

Kurtoğlu³

et al. 2015

Turk Neph Dial Transpl

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The syndrome of acute bilateral basal ganglia lesions associated with uremia presents with parkinsonism, altered mental status, and chorea in association with specific imaging findings in the basal ganglia. It is an uncommon syndrome seen generally in patients with diabetes mellitus and renal failure. We report a male patient with diabetes mellitus who received hemodialysis treatment 3 days a week for 5 years and suffered from choreic movements developed suddenly and associated with bilateral basal ganglia lesions. In the brain magnetic resonance (MR) imaging, isointense was detected in sequence T1 in the bilateral basal ganglions and hyperintense lesion was determined in T2 and FLAIR sequences. The patient was administered daily hemodialysis and neuroleptic treatment. After intensified hemodialysis, his symptoms and follow-up brain MR imaging showed marked improvement. The underlying mechanism of such lesions may be associated with metabolic, as well as vascular factors. Acute choreic movements may be seen in patients with diabetic nephropathy and intensification of hemodialysis treatment along with blood glucose regulation may provide improvement in this syndrome. KeY worDs: Basal ganglia, Chorea, Diabetes mellitus, Uremia ÖzÜremi ile ilişkili akut bilateral bazal ganglion lezyonları ile seyreden sendrom, parkinsonizm, mental durum değişikliği ve korea kliniği ile ortaya çıkan, bazal ganglionlarda spesifik görüntüleme bulguları saptanan bir durumdur. Bu nadir sendrom çoğunlukla diyabetik üremili hastalarda saptanmaktadır. Burada 5 yıldır haftada 3 gün düzenli hemodiyaliz tedavisi alan, ani gelişen koreik hareket bozukluğu olan ve bilateral bazal ganglion lezyonları ile ilişkilendirdiğimiz bir erkek hastayı sunmaya çalıştık. Beyin manyetik rezonans (MR) incelemesinde bazal ganglion seviyesinde T1 sekansında izointens T2 ve FLAİR sekanslarında hiperintens görüntüler saptandı. Hastaya nöroleptik tedavi ile birlikte günlük hemodiyaliz tedavisi uygulandı. Yoğun hemodiyaliz tedavisi sonrası semptomlarında ve kontrol MR bulgularında belirgin gerileme saptandı. Bu lezyonların temel mekanizması metabolik ve/veya vasküler nedenlerle ilişkili olabilir. Diyabetik nefropatili hastalarda görülen akut koreik hareket bozukluğunun yoğun hemodiyaliz tedavisi ve kan glukoz regülasyonu ile düzeltilebileceği kanısındayız.

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Section: Conclusıonsmentioning

confidence: 54%

“…The patients should be carefully assessed about dialysis sufficiency and acid-base and electrolyte abnormalities. reFerences involvement is not frequent (3)(4)(5). Acute movement disorder accompanied by bilateral basal ganglia involvement in patients with diabetic uremia is a separate clinical syndrome (3).…”

Section: Conclusıonsmentioning

confidence: 99%

Acute Chorea Characterized by Bilateral Basal Ganglia Lesions in a Patient with Diabetic Nephropathy

Doğan¹,

Kahvecioğlu²,

Kurtoğlu³

et al. 2015

Turk Neph Dial Transpl

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“…Üremik hastalarda simetrik bazal ganglion lezyonuna bağlı ani gelişen hareket bozukluğu nadir olarak görülen bir klinik tablodur 4 . Bu vakamızda ani olarak başlayan konuşma bozukluğu olan ve koreiform hareketleri olan hastaya klinik ve görüntüleme yöntemleri ile diyabetik üremik ensefalopati tanısı konulmuştur.…”

Section: Introductionunclassified

Diyabetik üremik hastada bazal ganglion tutulumu ve kore

İlik¹,

Büyükgöl²,

Öğmegül³

2014

Cukurova Medical Journal

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Diyabetik üremik hastalarda akut bilateral bazal gangliyon oluşumu ile ilişkili sendromlar yaygın değildir. Üremik ensefalopati tipik olarak kortikal tutulum gösterir. Konfüzyon, nöbetler, tremor ve myoklonik nöbetler görülür. Bazal gangliyonlar anatomik olarak tutulursa kore dahil hareket bozuklukları görülür. Biz bu vakada koreye neden olan, bazal gangliyon tutulumlu üremik diyabetik hastayı nadir görülmesi nedeniyle sunduk.

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“…Hegde et al 35 showed bilateral basal ganglia lesions in a 37-year-old HIVseropositive male with central nervous system toxoplasmosis by MRI. Lee et al 36 found that there was abnormality in bilateral basal ganglia in diabetic uremic patient by DWI. However, there are no contradictions between our study and their studies, [34][35][36] because our objects and the former research objects were different.…”

mentioning

confidence: 98%

“…However, many scholars [34][35][36] showed that there was abnormality in bilateral basal ganglia in some patients. Corti et al 34 found that there was abnormality in bilateral basal ganglia in patients with AIDS with central nervous system cryptococcosis.…”

mentioning

confidence: 99%

Application of brain multi-b-value diffusion-weighted imaging (DWI) in adolescent orphans from AIDS families

Jiang

Zhong

Zhou

et al. 2016

BJR

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Objective: To evaluate the application value of multib-value diffusion-weighted imaging (DWI) with monoexponential model and stretched-exponential model in the diagnosis of HIV-positive patients. Methods: 50, 150, 200, 400, 600, 800 s mm 22) DWI was performed in 23 adolescent orphans from AIDS families, including 15 HIV-positive subjects and 8 HIV-negative healthy subjects. Apparent diffusion coefficient (ADC) values were fitted by monoexponential model; distribution diffusion coefficient (DDC) values and heterogeneity index (a) values were fitted by stretched-exponential model in bilateral basal ganglia, then non-parametric tests were performed. Results: The signal intensity attenuation in multi-b-value DWI could be well described by both mono-exponential model and stretched-exponential model. In the left basal ganglia, mean a-values in HIV-positive subjects (a 5 0.848 6 0.068) were significantly lower than that in healthy subjects (a 5 0.923 6 0.050, p 5 0.013). There was no statistical difference of a-values between HIV-positive subjects and healthy control subjects in the right basal ganglia. Apart from these, there were also no statistical differences of DDC values or ADC values between two groups in bilateral basal ganglia (all p . , we can see stretched-exponential model DWI can provide more information than mono-exponential model DWI. Advances in knowledge: Multi-b-value DWI was performed in subjects with HIV. DWI measurements could be neuroimaging biomarkers of cerebral injury in the course of HIV infection.

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Acute bilateral basal ganglia lesions in diabetic uraemia: diffusion-weighted MRI

Cited by 56 publications

References 21 publications

Acute Chorea Characterized by Bilateral Basal Ganglia Lesions in a Patient with Diabetic Nephropathy

Acute Chorea Characterized by Bilateral Basal Ganglia Lesions in a Patient with Diabetic Nephropathy

Diyabetik üremik hastada bazal ganglion tutulumu ve kore

Application of brain multi-b-value diffusion-weighted imaging (DWI) in adolescent orphans from AIDS families

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