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高血糖相关运动障碍患者的前瞻性系列。

A prospective series of patients with hyperglycaemia-associated movement disorders.

机构信息

Clinical Neurodegenerative Disease Research Unit, National Institute of Neurology and Neurosurgery, Insurgentes Sur 3877 Tlalpan, Mexico City 14269, Mexico.

出版信息

J Clin Neurosci. 2011 Oct;18(10):1329-32. doi: 10.1016/j.jocn.2011.01.029. Epub 2011 Jul 23.

Abstract

Hyperglycaemia-associated movement disorders (MD) usually appear in older patients with diabetes and are related to acute peaks in blood glucose levels. This study aimed to describe the clinical features of a prospective series of patients with movement disorders associated with hyperglycaemia. We present a series of seven women and three men diagnosed with hyperglycaemia-associated MD who were followed for at least 1 year. Clinical evolution, treatment and neuroimaging findings are presented. Mean (± standard deviation [SD]) of the age at onset was 67.7 ± 11.7 years and mean (± SD) fasting glucose was 359.7 ± 162.5mg/dL. Putaminal hyperintensity on T1-weighted MRI was present in almost all instances. Two patients had pontine lesions compatible with osmotic myelinolysis. At follow-up, eight patients had a complete remission. We conclude that the clinical profile of patients in our series is similar to those reported in the literature. No clinical or metabolic features were found to be correlated with remission. Similarities with osmotic myelinolysis syndromes are discussed as an alternative aetiological hypothesis.

摘要

高血糖相关运动障碍(MD)通常出现在患有糖尿病的老年患者中,与血糖水平的急性峰值有关。本研究旨在描述与高血糖相关的运动障碍的前瞻性系列患者的临床特征。我们报告了一系列 7 名女性和 3 名男性患者,这些患者被诊断为高血糖相关 MD,且随访时间至少为 1 年。介绍了临床演变、治疗和神经影像学发现。发病时的平均(±标准差[SD])年龄为 67.7±11.7 岁,空腹血糖的平均(±SD)为 359.7±162.5mg/dL。几乎所有患者的 T1 加权 MRI 上均存在壳核高信号。2 例患者存在符合渗透性髓鞘溶解的桥脑病变。在随访时,8 例患者完全缓解。我们得出结论,我们系列中的患者的临床特征与文献报道的相似。未发现临床或代谢特征与缓解相关。讨论了与渗透性髓鞘溶解综合征相似的情况,作为一种替代病因假说。

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