Jergas Hannah, Baldermann Juan C, Wirths Jochen, Barbe Michael T, Visser-Vandewalle Veerle, Andrade Pablo
Department of Neurology, University Hospital Cologne, Cologne, Germany.
Department of Stereotactic and Functional Neurosurgery, University Hospital of Cologne, Cologne, Germany.
Surg Neurol Int. 2023 Jan 27;14:24. doi: 10.25259/SNI_716_2022. eCollection 2023.
Hyperkinetic movement disorders secondary to brain tissue damage due to hyperglycemia are a rare complication of diabetes mellitus. Nonketotic hyperglycemic hemichorea (NH-HC) is characterized by a rapid onset of involuntary movements after increased serum glucose levels.
We report on a case of a 62-year-old male patient with a 28-year history of Type II diabetes mellitus with NH-HC following an infect-associated exacerbation of blood glucose levels. Choreiform movements of the right upper extremity, face, and trunk persisted 6 months after onset. Due to failure of conservative treatments, we opted for unilateral deep brain stimulation of the globus pallidus internus, which led to complete cessation of symptoms within a week after initial programming. Symptom control was still satisfactory 12 months after surgery. No side-effects or surgery-associated complications were observed.
Globus pallidus internus DBS is an effective and safe treatment option for hyperkinetic movement disorders secondary to brain tissue damage caused by hyperglycemia. Postoperatively, stimulation effects can be observed quickly and effects persist even after 12 months.
高血糖导致脑组织损伤继发的运动亢进性运动障碍是糖尿病的一种罕见并发症。非酮症高血糖性偏侧舞蹈症（NH-HC）的特征是血清葡萄糖水平升高后迅速出现不自主运动。
我们报告一例62岁男性患者，有28年II型糖尿病病史，在感染相关的血糖水平恶化后出现NH-HC。右侧上肢、面部和躯干的舞蹈样动作在发病后持续了6个月。由于保守治疗失败，我们选择了内侧苍白球单侧深部脑刺激，在初始程控后一周内症状完全停止。术后12个月症状控制仍令人满意。未观察到副作用或手术相关并发症。
内侧苍白球深部脑刺激是高血糖导致脑组织损伤继发的运动亢进性运动障碍的一种有效且安全的治疗选择。术后可迅速观察到刺激效果，且效果在12个月后仍持续存在。
