Department of Gastroenterology and Diabetes, Hiraka General Hospital, Yokote, Japan.
Department of Cardiovascular Medicine, Hiraka General Hospital, Yokote, Japan.
Diabet Med. 2017 Dec;34(12):1795-1799. doi: 10.1111/dme.13526.
Diabetic striatopathy, one of the complications of diabetes mellitus, is characterized by involuntary movements, including hemichorea and hemiballismus, and the presence of hyperintense lesions on T1-weighted magnetic resonance imaging of the striatum.
We present a case of diabetic striatopathy manifesting as severe consciousness disturbance without chorea or ballismus. A 58-year-old man was admitted to our hospital in a state of unconsciousness. He was diagnosed with diabetic striatopathy as a result of extremely elevated blood glucose levels and typical magnetic resonance imaging findings in the left striatum, although involuntary movements were absent. He was treated with insulin, and his glucose levels were well maintained. His neuropsychiatric symptoms recovered, rather slowly but completely, after ~20 days.
This case indicates the diversity of striatal dysfunction induced by hyperglycaemia. For good prognosis of diabetic striatopathy, prompt diagnosis and appropriate treatments are important. Physicians should be aware that this disease can cause various neurological and psychiatric symptoms other than chorea or ballismus.
糖尿病纹状体病是糖尿病的并发症之一，其特征为不随意运动，包括偏侧舞蹈症和偏侧投掷症，以及纹状体 T1 加权磁共振成像上出现高信号病变。
我们报告了一例以严重意识障碍为表现的糖尿病纹状体病，无舞蹈症或投掷症。一名 58 岁男性因无意识入院。尽管无不随意运动，但由于血糖水平极高和左侧纹状体的典型磁共振成像表现，诊断为糖尿病纹状体病。他接受了胰岛素治疗，血糖水平得到了很好的控制。他的神经精神症状在 20 天左右逐渐完全恢复。
本例表明高血糖引起的纹状体功能障碍具有多样性。对于糖尿病纹状体病的良好预后，及时诊断和适当治疗非常重要。医生应该意识到，这种疾病除了舞蹈症或投掷症外，还可能引起各种神经和精神症状。
