[Hemichorea with Contralateral High Signal Intensity Putaminal Lesion on T1-Weighted Images in Non-Ketotic Hyperglycemia]

Fortschr Neurol Psychiatr. 2016 Apr;84(4):222-5. doi: 10.1055/s-0042-104347. Epub 2016 Apr 21.
[Article in German]

Abstract

A 64-year-old diabetic female patient presented with involuntary unilateral hyperkinetic movements of the left limbs. Cranial MRI showed a contralateral high signal intensity putaminal lesion on T1-weighted images without any signal changes in the T2-weighted images. This finding is characteristic for hemichorea-hemiballism associated with insufficiently treated diabetes mellitus. Additionally, proton MR spectroscopy was performed and revealed a decreased N-acetylaspartate/creatine and N-acetylaspartate/choline ratio, indicating neuronal damage of the contralateral putamen.

Publication types

  • Case Reports

MeSH terms

  • Aspartic Acid / analogs & derivatives
  • Aspartic Acid / metabolism
  • Choline / metabolism
  • Chorea / diagnostic imaging*
  • Chorea / physiopathology*
  • Creatine / metabolism
  • Diabetes Complications / diagnostic imaging*
  • Diabetes Complications / physiopathology*
  • Diabetes Mellitus, Type 2 / diagnostic imaging*
  • Diabetes Mellitus, Type 2 / physiopathology*
  • Diffusion Magnetic Resonance Imaging*
  • Dominance, Cerebral / physiology*
  • Female
  • Glycated Hemoglobin A / metabolism
  • Humans
  • Hyperglycinemia, Nonketotic / diagnostic imaging*
  • Hyperglycinemia, Nonketotic / physiopathology*
  • Magnetic Resonance Spectroscopy
  • Middle Aged
  • Putamen / diagnostic imaging*
  • Putamen / physiopathology*

Substances

  • Glycated Hemoglobin A
  • hemoglobin A1c protein, human
  • Aspartic Acid
  • N-acetylaspartate
  • Creatine
  • Choline