Hemichorea associated with non-ketotic hyperglycemia and cerebral blood flow hypoperfusion
10.3969/j.issn.1009-0126.2024.09.019
- VernacularTitle:非酮症高血糖性偏侧舞蹈症与脑血流低灌注
- Author:
Xiaoxiao NIE
1
;
Linlin CHAO
;
Mengmeng CAI
;
Jingjing SHI
;
Jianhua ZHAO
Author Information
1. 450003 郑州大学人民医院(河南省人民医院)神经内科
- Keywords:
diabetes mellitus,type 2;
chorea;
magnetic resonance angiography
- From:
Chinese Journal of Geriatric Heart Brain and Vessel Diseases
2024;26(9):1069-1072
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the clinical and imaging features of hemichorea associated with non-ketotic hyperglycemia(HC-NH)and to explore the perfusion of cerebral blood flow in the patients.Methods A retrospective study was conducted on 23 HC-NH patients diagnosed in Henan Provincial People's Hospital from January 2018 to December 2023.The clinical manifesta-tions,imaging features and prognosis were collected and analyzed,and the correlation with cere-bral blood flow hypoperfusion was investigated.Results The symptoms were all lateral involun-tary movements,of which 4 cases presented only single upper limb(1 case was left upper limb,the other 3 cases were right upper limb),and 19 cases had both upper and lower limbs involved(10 cases were left limb,and 9 cases were right limb).After the onset of the symptoms,the blood glucose level was 19.72±4.72 mmol/L,glycated hemoglobin level was(13.60±3.68)％,but all of patients were negative to urine ketone bodies.Hyperdense lesions in the contralateral basal ganglia region on CT images were observed in 6 cases.Strip or patchy hyperintensity was seen on T1-weighted MR images.All patients had ipsilateral stenosis of the vessels and regional hypoperfu-sion of cerebral blood flow as shown by MR perfusion-weighted imaging.All symptoms were re-lieved after actively controlling blood glucose,improving blood circulation,and symptomatic man-agement.Conclusion HC-NH is quite rare in clinical practice,and its occurrence may be related to cerebral blood flow hypoperfusion triggered by basal nucleus degeneration.
