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一种罕见的运动障碍——糖尿病性纹状体病病例

An Unusual Movement Disorder-Case of Diabetic Striatopathy.

作者信息

Azmat Shazia, Lodhi Owais, Ashok Harish, Harb Hussein, Siddiqui Mahwash, Gilden Janice

机构信息

Chicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA.

Department of Internal Medicine, Ascension Illinois-Saint Joseph Hospital, Chicago, IL 60657, USA.

出版信息

JCEM Case Rep. 2024 Oct 25;2(11):luae201. doi: 10.1210/jcemcr/luae201. eCollection 2024 Nov.

Abstract

Nonketotic hyperglycemia chorea-ballismus (NKH-CB), a rare metabolic syndrome, arises as a secondary condition to hyperglycemia. It is marked by acute or subacute hemichorea-hemiballismus, hyperglycemic state, and unique reversible striatal abnormalities on neuroimaging. This case presents a 70-year-old Hispanic man with a significant medical history of cerebral vascular accidents, hypertension, bipolar disease, and uncontrolled type 2 diabetes mellitus. Notably, the patient was experiencing large-amplitude involuntary movements on his left side for the past 3 weeks. With resolution of hyperglycemia, the amplitude and frequency of the involuntary arm movements were absent. This case highlights the need for careful monitoring and tight control of blood glucose levels in patients with a history of diabetes, to prevent serious neurological complications such as NKH-CB syndrome. Prompt diagnosis through neurological evaluation, blood glucose level assessment, and neuroimaging techniques are critical in managing the symptoms effectively.

摘要

非酮症高血糖性舞蹈症-手足徐动症(NKH-CB)是一种罕见的代谢综合征,是高血糖继发的病症。其特征为急性或亚急性偏侧舞蹈症-偏侧手足徐动症、高血糖状态以及神经影像学上独特的可逆性纹状体异常。该病例为一名70岁的西班牙裔男性,有脑血管意外、高血压、双相情感障碍和未得到控制的2型糖尿病等重要病史。值得注意的是,该患者在过去3周内左侧出现大幅度不自主运动。随着高血糖的缓解,不自主手臂运动的幅度和频率消失。该病例强调了对有糖尿病病史的患者进行血糖水平仔细监测和严格控制的必要性,以预防诸如NKH-CB综合征等严重的神经并发症。通过神经学评估、血糖水平评估和神经影像学技术进行及时诊断对于有效控制症状至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8569/11505440/07a65347cfd8/luae201f1.jpg

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