Hemichorea associated with diabetic hyperglycemia: a clinical characteristic analysis of 2 cases

Abstract

Objective To investigate the clinical characteristics and the imaging features of patients with hemichorea associated with hyperglycemia in primary diabetes mellitus (DM). Methods We retrospectively analyzed the clinical manifestations and the neuroimaging features of 2 patients with hemichorea induced by hyperglycemia in primary DM, admitted to our hospital on 9 and 29 October 2010; the related literatures about this disease were reviewed. Results These 2 patiewnts were both old female diabetics with acute onset of symptomatic hemichorea. One had an outbreak during using insulin to control blood glucose and the other did without using insulin; at first,case 2 symptom of one side chorea was showed,and then both sides were noted.CT findings indicated T1-high-density shadow in the contralateral caudate nucleus, putamen and globus pallidus (CT values in 50 Hu or so); MR imaging indicated that T1WI showed high-signal in the contralateral caudate nucleus,putamen and globus pallidus,while T2WI showed low-signal; partial light atrophy but no strengthening phenomenon in lesion location were noted. These patients were treated effectively with haloperidol and clonazepam.Conclusion Hemichorea induced by hyperglycemia often involves diabetic patients with poor glucose control. Characteristic imaging changes in the contralateral basal ganglia; blood glucose control is the foundation of treatment; haloperidol and clonazepam are helpful in controling hemichorea. Key words: Diabetes; Hemichorea; Clinical symptom; Imaging feature