Generalized chorea in the syndrome of acute bilateral basal ganglia lesions in patients with diabetic uremia

Abstract

The syndrome of acute bilateral basal ganglia (BG) lesions in patients with diabetic uremia normally affects Asian patients and usually presents with parkinsonian symptoms. We report two patients with this syndrome suffering from acute generalized choreic movements. The brain MRI of both patients revealed a cytotoxic-type of edema in the bilateral BG during the acute phase of the syndrome. After supportive treatment, they completely recovered from generalized chorea and the period of hyperkinesia corresponded to the acute exacerbation of the metabolic disturbance. Follow-up brain MRI revealed complete resolution of the abnormal signal. Thus, generalized chorea may be the initial presenting symptom of the syndrome and bilateral BG lesions probably originate from cytotoxic-type edema.