Department of Endocrinology and Metabolism, Tianjin First Central Hospital, Tianjin, China.
Department of Neurology, Tianjin First Central Hospital, Tianjin, China.
J Diabetes. 2024 Apr;16(4):e13543. doi: 10.1111/1753-0407.13543.
To summarize the clinical characteristics and imaging manifestations of patients with nonketotic hyperglycemic hemichorea (NH-HC) and to explore the possible pathogenesis, diagnosis. and treatment of the disease in order to improve the understanding of this disease and avoid misdiagnosis.
Retrospective analysis was performed on the case data of five patients with NH-HC admitted to our hospital in recent years. The patients were treated in the department of endocrinology, department of neurology, and department of neurosurgery in our hospital, respectively. Meanwhile, relevant literatures were consulted for further learning.
NH-HC is usually presented as a triad of nonketotic hyperglycemia, lateral chorea, and typical imaging manifestations of head magnetic resonance imaging or computed tomography, but the clinical manifestations are not the same, and imaging features may also be different, presenting a diversified trend in clinical practice. All five patients were given glucose-lowering drugs and improved with or without combination of drugs to control symptoms of chorea.
NH-HC is a rare complication of diabetes, characterized by hyperglycemia and hemichorea. How to identify the extreme situation and make fast judgment is a top priority. Timely and correct control of blood glucose is the key to the treatment, and when necessary, application of dopamine receptor antagonists in patients with combination therapy can accelerate improvement of the clinical symptoms. The prognosis of NH-HC is good, the clinician should strengthen comprehensive understanding of this disease to avoid missed diagnosis or misdiagnosis and enable patients to get more timely and effective treatment.
总结非酮症高血糖性偏侧舞蹈症（NH-HC）患者的临床特征和影像学表现，探讨该病的可能发病机制、诊断和治疗方法，以提高对该病的认识，避免误诊。
回顾性分析近年来我院内分泌科、神经内科和神经外科收治的 5 例 NH-HC 患者的病例资料，并查阅相关文献进行进一步学习。
NH-HC 常表现为非酮症高血糖、偏侧舞蹈症和典型的头部磁共振成像或计算机断层扫描影像学表现，但临床表现不尽相同，影像学特征也可能存在差异，在临床实践中呈现出多样化的趋势。5 例患者均给予降血糖药物治疗，联合或不联合药物控制舞蹈症状均有改善。
NH-HC 是糖尿病的一种罕见并发症，以高血糖和偏侧舞蹈症为特征。如何识别这种极端情况并做出快速判断是当务之急。及时、正确地控制血糖是治疗的关键，必要时联合应用多巴胺受体拮抗剂可加速改善临床症状。NH-HC 的预后良好，临床医生应加强对该病的全面认识，避免漏诊或误诊，使患者得到更及时、有效的治疗。
