Hemichorea in nonketotic hyperglycemia: Putamenal and cerebellum lesion on MR imaging

DOI: 10.4236/wjns.2012.22020   PDF   HTML   XML   5,373 Downloads   10,547 Views   Citations


Hemichorea with corresponding putamenal T1 hyper-intensity and T2 hypointensity on MR imaging has occasionally been reported in diabetes mellitus with nonketotic hyperglycemia. However, the signal intensity in pu-tamenal and cerebellum lesion on MR imaging, which is believed to be pathogenetically related to hemichorea, is rarely documented in diabetes mellitus with nonketotic hyperglycemia. We describe a 57-year-old man with nonketotic hyperglycemic hemichorea on his right arm and legs, whose signal intensity in putamenal and cerebellum lesion was demonstrated by MR imaging.

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Zhou, Y. , Wang, G. , Chen, X. , Yang, T. , Wang, Y. , Chang, C. , Wang, Y. , Gu, H. , Bao, J. , Xu, G. and Tong, D. (2012) Hemichorea in nonketotic hyperglycemia: Putamenal and cerebellum lesion on MR imaging. World Journal of Neuroscience, 2, 138-140. doi: 10.4236/wjns.2012.22020.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Dell, L.A., Brown, M.S., Orrison, W.W., Eckel, C.G. and Matwiiyoff, N.A. (1988) Physiologic intracranial calcification withhyperintensity on MR imaging: Case report and experimental model. American Journal of Neuroradiology, 9, 1145-1138.
[2] Henkelmen, R.M., Walts, J.F. and Kucharczyk, W. (1991) High signal intencity in MR images of calcified brain tissue. Radiology, 179, 199-206.
[3] Nagai, C., Kato, T., Katagiri, T. and Sasaki, H. (1995) Hyperintense putamen on T1-weighted MR images in a case of chorea with hyperglycemia. American Journal of Neuroradiology, 16, 1243-1246.
[4] Lai, P.H., Tien, R.D., Chang, M.H., et al. (1996) Chorea-ballismus with nonketotic hyperglycemia in primary diabetes mellitus. American Journal of Neuroradiology, 17, 1057-1064
[5] Chang, M.H., Chiang, H.T., Lai, P.H., et al. (1997) Putaminal petechial haemorrhage as the cause of chorea: A neuroimaging study. Journal of Neurology, Neurosurgery, and Psychiatry, 63, 300-303. doi:10.1136/jnnp.63.3.300
[6] Cherian, A., Thomas, B. and Baheti, N.N. (2009) Chemmanam T, Kesavadas C.Concepts and controversies in nonketotic hyperglycemia-induced hemichorea: Further evidence from susceptibility-weighted MR imaging. Journal of Magnetic Resonance Imaging, 29, 699-703. doi:10.1002/jmri.21672
[7] Chu, K., Kang, D.-W., Kim, D.-E., Park, S.-H. and Roh. J.-K. (2002) Diffusion-Weighted and Gradient Echo Magnetic Resonance Findings of Hemichorea-Hemiballismus Associated With Diabetic Hyperglycemia: A Hyperviscosity Syndrome? Archives of Neurology, 59, 448-452. doi:10.1001/archneur.59.3.448
[8] Ohara, S., Nakagawa, S., Tabata, K. and Hashimoto, T. (2001) Hemiballism with hyperglycemia and striatal T1-MRI hyperintensity: An autopsy report. Movement Disorders, 16, 521-525. doi:10.1002/mds.1110
[9] Chang, K.H., Tsou, J.C., Chen, S.T., Ro, L.S., Lyu, R.K., Chang, H.S., Hsu, W.C., Chen, C.M., Wu, Y.R. and Chen, C.J. (2010)Temporal features of magnetic resonance imaging and spectroscopy in non-ketotic hyperglycemic chorea-ballism patients. European Journal of Neurology, 17, 589-593. doi:10.1111/j.1468-1331.2009.02867.x
[10] Fujioka, M., Taoka, T., Matsuo, Y., et al. (2003)Magnetic resonance imaging shows delayed ischemic striatal neurodegeneration. Annals of Neurology, 54, 732-747. doi:10.1002/ana.10751
[11] Iwata, A., Koike, F., Arasaki, K. and Tamaki, M. (1999) Blood brain barrier destruction in hyperglycemic chorea in a patient with poorly controlled diabetes. Journal of the Neurological Sciences, 163, 90-93. doi:10.1016/S0022-510X(98)00325-6
[12] Cheema, H., Federman, D. and Kam, A. (2011) Hemichorea-hemiballismus in non-ketotic hyperglycaemia. Journal of Clinical Neuroscience, 18, 293-294. doi:10.1016/j.jocn.2010.04.036
[13] Greene, D.A., Stevens, M.G., Obrosova, I. and Feldman, E.L. (1999) Glucose induced oxidative stress and programmed cell death in diabetic neuropathy. European Journal of Pharmacology, 375, 217-223. doi:10.1016/S0014-2999(99)00356-8
[14] Fujioka, M., Taoka, T., Matsuo, Y., Hiramatsu, K.I. and Sakaki, T. (1999) Novel brain ischemic change on MRI: delayed ischemic hyperintensity on T1-weighted images and selective neuronal death in the caudoputamen of rats after brief focal ischemia. Stroke, 30, 1043-1046. doi:10.1161/01.STR.30.5.1043
[15] Sharifi, A.M., Mousavi, S.H., Harhadi, M. and Larijani, B. (2007) Study of high glucose-indused apoptosis in Pc12Cells: Role of Bax protein. Journal of Pharmacological Sciences, 104, 258-262. doi:10.1254/jphs.FP0070258
[16] Li, Z.G., Zhang, W. and Sima, A.A. (2005) The role of impaired insulin/IGF action in primary diabetic encephalopathy. Brain Research, 1037, 12-24.
[17] Raghavendra, S., Ashalatha, R., Thomas, S.V. and Kesavadas, C. (2007) Focal neuronal loss, reversible subcortical focal T2 hypointensity in seizures with a nonketotic hyperglycemic hyperosmolar state. Neuroradiology, 49, 299-305. doi:10.1007/s00234-006-0189-6
[18] El Otmani, H., Moutaouakil, F., Fadel, H., El Ouafi, N., Abdoh Rafai, M., El Moutaouakil, B. and Slassi, I. (2009) Chorea-ballismus in acute non-ketotic hyperglycaemia. Functional Neurology, 24, 129-132.

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