Hemifacial spasm followed by predominantly unilateral upper limb monochorea unmasking type-2 diabetes mellitus

Ghosh, Ritwik; Roy, Dipayan; Das, Shambaditya; Benito‐León, Julián

doi:10.1016/j.nrleng.2021.12.004

Cited by 2 publications

(5 citation statements)

References 12 publications

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“…This underpins the importance of measuring capillary blood glucose immediately with any acute onset movement disorders, including those not classically described in diabetic striatopathy [13][14][15][16].…”

Section: Discussionmentioning

confidence: 99%

“…Interestingly, almost one third of movement disorders were nonchoreic and nonballistic, which is not the common perception. This underpins the importance of measuring capillary blood glucose immediately with any acute onset movement disorders, including those not classically described in diabetic striatopathy [13–16].…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Previous clinical series and systematic review regarding acute onset movement disorders in diabetes mellitus (DM) included only patients with chorea or ballism (Table 1) [1‐10]. However, in the past few years, different case reports describing other movement disorders apart from chorea and ballism have been reported [13‐16]. There is a knowledge gap, as no previous study has assessed the frequency and clinical–radiological characteristics of patients with DM and acute onset movement disorders, including nonchoreic and nonballistic movements.…”

Section: Introductionmentioning

confidence: 99%

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Acute onset movement disorders in diabetes mellitus: A clinical series of 59 patients

Dubey

Chatterjee

Ghosh

et al. 2022

Euro J of Neurology

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Background and purpose No previous study has assessed the frequency and clinical–radiological characteristics of patients with diabetes mellitus (DM) and acute onset nonchoreic and nonballistic movements. We conducted a prospective study to investigate the spectrum of acute onset movement disorders in DM. Methods We recruited all the patients with acute onset movement disorders and hyperglycemia who attended the wards of three hospitals in West Bengal, India from August 2014 to July 2021. Results Among the 59 patients (mean age = 55.4 ± 14.3 years, 52.5% men) who were included, 41 (69.5%) had choreic or ballistic movements, and 18 (30.5%) had nonchoreic and nonballistic movements. Ballism was the most common movement disorder (n = 18, 30.5%), followed by pure chorea (n = 15, 25.4%), choreoathetosis (n = 8, 13.6%), tremor (n = 5, 8.5%), hemifacial spasm (n = 3, 5.1%), parkinsonism (n = 3, 5.1%), myoclonus (n = 3, 5.1%), dystonia (n = 2, 3.4%), and restless leg syndrome (n = 2, 3.4%). The mean duration of DM was 9.8 ± 11.4 years (89.8% of the patients had type 2 DM). Nonketotic hyperglycemia was frequently (76.3%) detected. The majority (55.9%) had no magnetic resonance imaging (MRI) changes; the remaining showed striatal hyperintensity. Eight patients with MRI changes exhibited discordance with sidedness of movements. Most of the patients (76.3%) recovered completely. Conclusions This is the largest clinical series depicting the clinical–radiological spectrum of acute onset movement disorders in DM. Of note was that almost one third of patients had nonchoreic and nonballistic movements. Our findings highlight the importance of a capillary blood glucose measurement in patients with acute or subacute onset movement disorders, irrespective of their past glycemic status.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Acute onset movement disorders in diabetes mellitus: A clinical series of 59 patients

Dubey

Chatterjee

Ghosh

et al. 2022

Euro J of Neurology

Self Cite

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“…Non-ketotic hyperglycemia, unilateral limb choreographic dyskinesia, and striatal abnormalities on neuroimaging are typical signs of DS. Previous studies have found that chorea associated with hyperglycemia occurs mostly unilaterally and rarely bilaterally; a few may occur in hypoglycemic states or after correction of hyperglycemia [ 1 , 16 – 18 ], and a few DS cases reported no chorea [ 18 – 20 ] or had nonchoreic and nonballistic movements [ 7 , 12 , 14 , 18 , 21 , 22 ]. The imaging manifestation may also be unremarkable [ 16 , 18 , 23 ].…”

Section: Discussionmentioning

confidence: 99%

Clinical and imaging features of diabetic striatopathy: report of 6 cases and literature review

Shi

Yue

et al. 2022

Neurol Sci

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Objective To explore the clinical manifestations, diagnosis, treatment, and pathogenesis of diabetic striatopathy (DS) to improve the understanding of the disease and avoid misdiagnosis or underdiagnosis. Methods The clinical, laboratory, and imaging data of 6 patients (5 Asian females and 1 Asian male) with diabetic striatum were analyzed retrospectively, and the related literature was reviewed. Results All 6 patients showed hyperglycemia, 5 patients presented with involuntary movement of unilateral limbs, and 1 with unilateral limb numbness. Besides, 5 patients (except case 3) underwent MRI examinations that showed hyperintensity in unilateral caudate and lentiform nucleus on T1-weighted images. And all 6 patients who underwent brain CT examinations showed hyperdensity or isodensity in unilateral caudate and lentiform nucleus. None had a family history of similar abnormal movements. After blood glucose control and symptomatic support treatment, the symptoms of all patients improved to various degrees, and reexaminations showed that the lesions gradually disappeared. Conclusion Diabetic striatal disease is a rare complication of diabetes mellitus, the result of a combination of different pathogenesis. It is characterized by hyperglycemia, hemichorea, and contralateral striatal T1WI hyperintensity or CT hyperdensity. Both ketosis and nonketotic hyperglycemic hemichorea have typical imaging manifestations. The prognosis is excellent when this disease is detected early, and the lesions can be gradually absorbed and dissipated with glycemic control.

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Hemifacial spasm followed by predominantly unilateral upper limb monochorea unmasking type-2 diabetes mellitus

Cited by 2 publications

References 12 publications

Acute onset movement disorders in diabetes mellitus: A clinical series of 59 patients

Acute onset movement disorders in diabetes mellitus: A clinical series of 59 patients

Clinical and imaging features of diabetic striatopathy: report of 6 cases and literature review

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