Chorea, Hyperglycemia, Basal Ganglia Syndrome

Madu, Ezemonye; Alam, Hamid

doi:10.7556/jaoa.2015.099

Cited by 3 publications

(1 citation statement)

References 3 publications

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“…La sintomatología tiende a mostrar movimientos anormales e involuntarios que con mayor frecuencia muestran una afectación unilateral de las extremidades y que fluyen de una parte del ( 6) cuerpo a otra . Generalmente se asocia a un área hiperdensa en la tomografía computarizada o una señal hiperintensa potenciada en T1 en los ganglios basales en la resonancia magnética.…”

Section: Introductionunclassified

Long duration hemichorea associated with metabolic disorder

Chico

Lucero

Calderón³

2019

Rev. virtual Soc. Parag. Med. Int

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La corea asociada a la hiperglucemia representa un síndrome neurológico poco frecuente, mucho más común entre las mujeres asiáticas mayores. La fisiopatología sigue siendo controvertida y poco comprendida. Sin embargo, se han propuesto teorías como el aumento de la sensibilidad del receptor de dopamina, el infarto del núcleo estriado, el aumento del metabolismo del ácido gammaaminobutírico y una alteración de la barrera hematoencefálica. Informamos que una mujer de 75 años de edad, de raza indígena, fue ingresada en el Departamento de emergencias debido a movimientos aleatorios, involuntarios y continuos severos en su brazo y pierna derecha que comenzaron 3 días antes, acompañados de síntomas osmóticos (polidipsia y poliuria). El nivel de glucosa capilar al ingreso fue 470,5 mg/dL, sin rastros de cetona en sangre u orina, mientras que el valor de hemoglobina glicosilada fue 15,4%. La resonancia magnética nuclear reportó hiperintensidad en T1 del núcleo lenticular izquierdo predominantemente a nivel del putamen sin otras alteraciones. Describimos los aspectos de la larga duración de los síntomas a pesar del tratamiento y el control metabólico adecuado.

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Section: Introductionunclassified

Long duration hemichorea associated with metabolic disorder

Chico

Lucero

Calderón³

2019

Rev. virtual Soc. Parag. Med. Int

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Diabetic striatopathy: an updated overview of current knowledge and future perspectives

Arecco

Ottaviani

Boschetti

et al. 2023

J Endocrinol Invest

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Purpose Diabetic striatopathy (DS) is a rare complication of poorly controlled diabetes mellitus (DM), characterized by hyperglycemia associated with chorea/ballism and characteristic reversible basal ganglia abnormalities on computed tomography (CT) and/or magnetic resonance imaging (MRI). We propose a narrative review of the literature on this topic, currently unknown to most, and about which physicians should be aware. We intend to summarize, critically review, and take to mean the evidence on this disorder, describing its typical features. Methods We searched Pubmed for English-language sources using the following keywords in the title and the abstract: diabetic striatopathy, hyperglycemic non-ketotic hemichorea/hemiballism, chorea/hemichorea associated with non-ketotic hyperglycemia, diabetic hemiballism/hemichorea, chorea, hyperglycemia, and basal ganglia syndrome. We collected scientific articles, including case reports, reviews, systematic reviews, and meta-analyses from the years 1975 to 2023. We eliminated duplicate, non-English language or non-related articles. Results Older Asian women are more frequently affected. Suddenly or insidiously hemichorea/hemiballism, mainly in the limbs, and high blood glucose with elevated HbA1c in the absence of ketone bodies have been observed. Furthermore, CT striatal hyperdensity and T1-weighted MRI hyperintensity have been observed. DS is often a treatable disease following proper hydration and insulin administration. Histopathological findings are variable, and no comprehensive hypothesis explains the atypical cases reported. Conclusion DS is a rare neurological manifestation of DM. If adequately treated, although treatment guidelines are lacking, the prognosis is good and life-threatening complications may occur occasionally. During chorea/hemiballism, we recommend blood glucose and HbA1c evaluation. Further studies are needed to understand the pathogenesis.

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