Lucassen Elisabeth B, Delfyett William T, Stahl Mark C
Department of Neurology, Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA.
Department of Radiology, UPMC Presbyterian Hospital, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
Case Rep Neurol. 2017 Dec 18;9(3):299-303. doi: 10.1159/000484201. eCollection 2017 Sep-Dec.
Neurological complications of diabetes and hyperglycemia are relatively common but the specific manifestations can vary widely. Diabetic striatal disease or "diabetic striatopathy" is an uncommon condition usually thought to result from hyperglycemic injury to the basal ganglia, producing a hyperkinetic movement disorder, usually choreiform in nature. Symptoms are generally reversible with treatment of the hyperglycemia.
We report the case of a 57-year-old woman presenting with a unilateral choreoathetosis of the left upper extremity, persistent for 4 years. Contemporaneous imaging demonstrated severe atrophy of the right caudate nucleus, while imaging obtained at the onset of symptoms was consistent with a right diabetic striatopathy. Symptoms improved with the use of dopamine antagonists and benzodiazepines.
Although generally considered to be fully reversible, this case demonstrates that diabetic striatopathy can result in permanent structural lesions with persistent symptoms if left untreated.
糖尿病和高血糖的神经并发症相对常见，但具体表现差异很大。糖尿病纹状体疾病或“糖尿病纹状体病变”是一种罕见病症，通常认为是由基底节区高血糖损伤所致，会产生一种运动亢进性运动障碍，通常为舞蹈样动作。高血糖得到治疗后，症状一般可逆。
我们报告了一名57岁女性病例，该患者左上肢出现单侧舞蹈手足徐动症，持续4年。同期影像学检查显示右侧尾状核严重萎缩，而症状出现时的影像学检查结果符合右侧糖尿病纹状体病变。使用多巴胺拮抗剂和苯二氮䓬类药物后症状有所改善。
尽管通常认为糖尿病纹状体病变完全可逆，但该病例表明，如果不进行治疗，糖尿病纹状体病变可能导致永久性结构损伤并伴有持续症状。
