Chatterjee Subhankar, Biswas Payel, Sengupta Samya, Das Shambaditya, Ghosh Ritwik, Bhattacharjee Rana, Benito-León Julián, Dubey Souvik
Department of Endocrinology & Metabolism, Medical College & Hospital, Kolkata, India.
Department of Radiology, GNRC Hospital, Barasat, Kolkata, India.
Qatar Med J. 2025 Jun 9;2025(2):60. doi: 10.5339/qmj.2025.60. eCollection 2025.
Diabetic striatopathy (DS) typically presents with hemichoreoballism and contralateral striatal lesions on neuroimaging. However, cases of unilateral movement disorders with predominant ipsilateral striatal lesions are rare.
We present a case of DS in a 62-year-old woman from rural India with poorly controlled diabetes mellitus who developed acute-onset right hemichoreoballism. Neuroimaging revealed a predominantly right-sided striatal lesion, illustrating a clinicoradiological discordance-a mismatch between the clinical symptoms and radiological findings. Despite achieving tight glycemic control and administering neuroleptic medications, the involuntary movements demonstrated only partial improvement. Neurological changes persisted on the ipsilateral side of the affected limbs even after 1 year of follow-up. Notably, perioral dyskinesias developed during subsequent follow-up visits.
This report highlights the clinical and neuroradiological discordance observed in DS. The potential underlying mechanisms contributing to this paradox are explored and discussed.
The clinical and radiological discordance in DS is a frequent yet under-reported phenomenon. However, the actual mechanistic underpinnings need to be addressed by advanced functional and structural neuroimaging.
糖尿病性纹状体病（DS）通常表现为偏侧舞蹈症和神经影像学上对侧纹状体病变。然而，以同侧纹状体病变为主的单侧运动障碍病例罕见。
我们报告一例来自印度农村的62岁女性DS患者，其糖尿病控制不佳，突发急性右侧偏侧舞蹈症。神经影像学显示主要为右侧纹状体病变，呈现出临床与放射学不一致——临床症状与影像学表现不匹配。尽管实现了严格的血糖控制并给予了抗精神病药物治疗，但不自主运动仅部分改善。随访1年后，受累肢体同侧的神经学改变仍持续存在。值得注意的是，在随后的随访中出现了口周运动障碍。
本报告强调了DS中观察到的临床和神经放射学不一致。探讨并讨论了导致这种矛盾现象的潜在机制。
DS中的临床和放射学不一致是一种常见但报告不足的现象。然而，实际的机制基础需要通过先进的功能和结构神经影像学来解决。
