Easily missed or misinterpreted: diabetic striatopathy in the course of ketotic hyperglycaemia

Markowska, Katarzyna; Koziorowska-Gawron, Ewa; Papier, Paulina; Koszewicz, Magdalena; Budrewićz, Sławomir; Bladowska, Joanna; Zimny, Anna

doi:10.1136/postgradmedj-2020-139499

Cited by 2 publications

(1 citation statement)

References 3 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…DS prominently occurs in Asian women, particularly these patients with newly diagnosed or poorly controlled diabetes. Although most patients with DS were negative for ketone bodies, some patients still suffered from episodes of ketotic hyperglycemia (Tan et al, 2014 ; Markowska et al, 2021 ).…”

Section: Discussionmentioning

confidence: 99%

Diabetic Striatopathy Complicated With Acute Ischemic Stroke: A Case Report

et al. 2022

Front. Neurosci.

View full text Add to dashboard Cite

Diabetic striatopathy (DS) is a rare complication secondary to hyperglycemia, featured by the choreiform movements and reversible striatal abnormalities on neuroimaging. Several studies have described the clinical characteristics of DS, however, the simultaneous occurrence of DS and acute ischemic stroke (AIS) in the striatum has not been reported. Herein, we report a 68-year-old man with uncontrolled type 2 diabetes who experienced the progressive involuntary movement of the right upper and lower limbs for 10 days. We initially considered this patient as an AIS with hemorrhage in the left basal ganglia and adjacent area because his brain magnetic resonance imaging (MRI) showed hyperintensity on fluid-attenuated inversion recovery (FLAIR) and diffusion-weighted imaging (DWI) images, as well as slight T1-hyperintensity around T1-hypointensity. However, his symptoms worsen persistently, which was inconsistent with neuroimaging findings. Further computed tomography (CT) scan revealed an extensive hyper-density and focal low-density in the left striatum, suggesting the diagnosis of DS and AIS. His symptoms were in complete remission after 2 months of glucose control. However, striatal hyperintensity on T1 images was significantly increased compared to the initial images, which disappeared 18 months later. Additionally, DWI hyperintensity on infarction lesions disappeared, while softening lesions and gliosis were observed on the follow-up MRI images. Therefore, we finally diagnosed the patient as DS complicated with AIS. This report highlights that DS and AIS could occur simultaneously in the striatum after hyperglycemia, which is easily misdiagnosed as AIS with hemorrhage and requires clinicians to pay more attention to avoid misdiagnosis and delayed treatment.

show abstract

Section: Discussionmentioning

confidence: 99%

Diabetic Striatopathy Complicated With Acute Ischemic Stroke: A Case Report

et al. 2022

Front. Neurosci.

View full text Add to dashboard Cite

show abstract

A Case Report and Literature Review of Nonketotic Hyperglycemic Hemichorea

Blackbourn,

Uppu,

Zubair

et al. 2024

Cureus

View full text Add to dashboard Cite

Nonketogenic hyperglycemic hemichorea, also recognized as diabetic striatopathy, is a rare manifestation of diabetes mellitus. The diagnosis of nonketotic hyperglycemic hemichorea is usually made through imaging along with a corresponding clinical picture. Early identification and treatment can lead to complete resolution of the symptoms and better patient outcomes. Here we present a 49-year-old female patient, with a past medical history of poorly controlled type 2 diabetes mellitus and prior left index finger amputation as a complication of her diabetes, who presented for evaluation of a two-week duration of sudden-onset left upper extremity choreiform movements.

show abstract

Easily missed or misinterpreted: diabetic striatopathy in the course of ketotic hyperglycaemia

Cited by 2 publications

References 3 publications

Diabetic Striatopathy Complicated With Acute Ischemic Stroke: A Case Report

Diabetic Striatopathy Complicated With Acute Ischemic Stroke: A Case Report

A Case Report and Literature Review of Nonketotic Hyperglycemic Hemichorea

Contact Info

Product

Resources

About