Akande T O, Olalusi O V, Olulana D I
Department of Medicine, University College Hospital, Ibadan, Nigeria.
Department of Surgery, University of Ibadan and University College Hospital, Ibadan, Nigeria.
Ann Ib Postgrad Med. 2023 Aug;21(2):98-102. Epub 2023 Nov 1.
Diabetes mellitus is a disease with diverse macrovascular and microvascular consequences. One of the unusual effects of hyperglycemia is involuntary movement, termed hyperglycemia-induced involuntary movement. This could range from hemibalismus, chorea, choreo-atethosis, tremors to dystonia. Chorea associated with dystonia is a less commonly reported manifestation. When it is focal, it can be misdiagnosed as stroke or seizure disorder. To the best our knowledge, there is hitherto no case report in sub-Saharan Africa describing the occurrence of focal choreo-dystonia in type 2 Diabetes Mellitus.
Here, we present a case of a middle-aged Nigerian woman with focal choreo-dystonia of the right upper limb accompanying the diagnosis of type 2 diabetes. Achieving euglycemia with insulin resulted in complete resolution of the choreo-dystonia.
Doctors in resource-constrained settings should be aware of this presentation to avoid misdiagnosis and to provide prompt and goal-oriented management with a view to reducing morbidity and attendant health-care costs.
糖尿病是一种会引发多种大血管和微血管病变的疾病。高血糖的一种异常影响是不自主运动，称为高血糖诱导的不自主运动。其表现形式多样，从偏身投掷运动、舞蹈症、舞蹈手足徐动症、震颤到肌张力障碍不等。伴有肌张力障碍的舞蹈症是一种较少见的表现。当它为局灶性时，可能会被误诊为中风或癫痫发作障碍。据我们所知，撒哈拉以南非洲地区迄今尚无关于2型糖尿病患者发生局灶性舞蹈样肌张力障碍的病例报告。
在此，我们报告一例中年尼日利亚女性病例，该患者在被诊断为2型糖尿病的同时伴有右上肢局灶性舞蹈样肌张力障碍。使用胰岛素使血糖正常化后，舞蹈样肌张力障碍完全缓解。
资源有限地区的医生应了解这种表现，以避免误诊，并提供及时且目标明确的治疗，从而降低发病率和相关医疗费用。
