Yasuhara Akihiro, Wada Jun, Makino Hirofumi
Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Okayama, Japan.
J Med Case Rep. 2008 Nov 18;2:352. doi: 10.1186/1752-1947-2-352.
Diabetic hemichorea-hemiballismus is a rare complication of type 2 diabetes. Here, we report a case with type 1 diabetes, with hemichorea and bilateral dystonia manifested as hyperglycemia-induced involuntary movement.
A 62-year-old Japanese women with body weight loss of 30 kg during the past year developed symptoms of thirst, polydipsia and polyuria. She also presented with hemichorea and bilateral dystonia for 5 days and extremely high plasma glucose (774 mg/dl), hemoglobin A1c (21.2%) and glycated albumin (100%) with ketosis. Based on the presence of glutamic acid decarboxylase antibodies (18,000 U/ml; normal <1.3 U/ml), low daily urinary excretion of C-peptide (7.8 micro), ketosis and human leucocyte antigen typing DR-4, we diagnosed type 1 diabetes mellitus. We treated the patient with a continuous intravenous regular insulin infusion and medication with haloperidol, and dystonia completely disappeared within 3 days.
Hyperglycemia-induced involuntary movement is one of the manifestations of dystonia and hemichorea-hemiballism.
糖尿病性偏侧舞蹈症 - 偏侧投掷症是2型糖尿病的一种罕见并发症。在此，我们报告一例1型糖尿病患者，其偏侧舞蹈症和双侧肌张力障碍表现为高血糖诱导的不自主运动。
一名62岁的日本女性，在过去一年体重减轻30公斤，出现口渴、多饮和多尿症状。她还出现偏侧舞蹈症和双侧肌张力障碍5天，血浆葡萄糖水平极高（774毫克/分升）、糖化血红蛋白（21.2%）和糖化白蛋白（100%）并伴有酮症。基于谷氨酸脱羧酶抗体的存在（18,000 U/ml；正常<1.3 U/ml）、每日尿C肽排泄量低（7.8微克）、酮症以及人类白细胞抗原分型DR - 4，我们诊断为1型糖尿病。我们对患者进行持续静脉输注正规胰岛素治疗并给予氟哌啶醇药物治疗，肌张力障碍在3天内完全消失。
高血糖诱导的不自主运动是肌张力障碍和偏侧舞蹈症 - 偏侧投掷症的表现之一。
