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Keywords = Hemichorea-hemiballism

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10 pages, 3434 KiB  
Case Report
Diabetic Striatopathy: Parenchymal Transcranial Sonography as a Supplement to Diagnosis at the Emergency Department
by Massimiliano Godani and Giuseppe Lanza
Diagnostics 2022, 12(11), 2838; https://doi.org/10.3390/diagnostics12112838 - 17 Nov 2022
Cited by 6 | Viewed by 2073
Abstract
Background: Diabetic striatopathy (DS) is a rare condition with a debated pathophysiology; a local metabolic dysfunction is the most likely hypothesis. We present a case of DS mimicking an acute stroke, outline a few uncommon/atypical features, and report for the first time [...] Read more.
Background: Diabetic striatopathy (DS) is a rare condition with a debated pathophysiology; a local metabolic dysfunction is the most likely hypothesis. We present a case of DS mimicking an acute stroke, outline a few uncommon/atypical features, and report for the first time the parenchymal transcranial sonography (pTCS) findings. Case Report: An 86-year-old man, treated for insulin-dependent diabetes, presented at an emergency department because of the occurrence of isolated choreo-athetotic movements in his left limbs with fluctuations in the location, frequency, and duration. The blood glucose level was 569 mg/dL. Both urgent and follow-up brain computed tomography (CT) were negative for recent lesions whereas pTCS revealed hyperechogenicity in the right lenticular nucleus. Subsequent magnetic resonance imaging (MRI) showed T1-weighted hyperintensity in the right putamen with negative diffusion-weighted imaging. The symptoms were responsive to glucose control and haloperidol administration, although they persisted during sleep. Conclusions: Unlike previously described cases characterized by hemichorea and/or hemiballism, our patient presented with a stroke-like onset of unilateral irregular choreo-athetotic movements. Notably, based on CT alone, it would not have been possible to distinguish DS from a stroke. In this scenario, the pTCS hyperechogenicity of the right lenticular nucleus helped to hypothesize a metabolic disorder, which was subsequently confirmed by MRI. Full article
(This article belongs to the Special Issue Advances in the Pathology of Lung, Brain, and Heart Diseases)
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6 pages, 2167 KiB  
Case Report
Clinical and Neuroimaging Features in a Patient with Non-Ketotic Hyperglycemia
by Yonghua Zhang and Aasheeta Parikh
Neurol. Int. 2020, 12(3), 130-135; https://doi.org/10.3390/neurolint12030018 - 14 Dec 2020
Cited by 2 | Viewed by 3201
Abstract
Hemichorea–hemiballism (HC–HB) is a spectrum of involuntary flinging and flailing, non-patterned, irregular movements involving one side of the body. A rare dysfunction of glucose metabolism leading to a state of non-ketotic hyperglycemia (NKH) is thought to be a cause of these symptoms. In [...] Read more.
Hemichorea–hemiballism (HC–HB) is a spectrum of involuntary flinging and flailing, non-patterned, irregular movements involving one side of the body. A rare dysfunction of glucose metabolism leading to a state of non-ketotic hyperglycemia (NKH) is thought to be a cause of these symptoms. In previous case studies, imaging findings have been in the basal ganglia as hyperintense lesions on magnetic resonance imaging (MRI) or hyperdensities on computerized tomography (CT). This case is unique due to abnormal findings in the MRI T2/fluid-attenuated inversion recovery (FLAIR) sequence in areas not previously reported—the thalamus and midbrain/pons. As in other NKH cases, the patient improved both clinically and radiologically. In patients with uncontrolled diabetes and abnormal movements, monitoring of blood glucose is imperative as it can lead to recognition of HC–HB. Other etiologies, including stroke, neoplasm, demyelination, and inflammatory processes, have uncertain prognoses with unfavorable outcomes. The prognosis for NKH is usually favorable, and thus important to identify. Full article
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3 pages, 449 KiB  
Article
Clinical features of hemichoreahemiballism: A stroke-related movement disorder
by Nobuko Shiraiwa, Sachiko Hoshino, Go Saito, Akira Tamaoka and Norio Ohkoshi
Neurol. Int. 2020, 12(1), 8328; https://doi.org/10.4081/ni.2020.8328 - 10 Jul 2020
Cited by 1 | Viewed by 969
Abstract
We examined pathogenesis and clinical features of three hemichorea-hemiballism (HCHB) cases. We studied their age, magnetic resonance imaging results, vascular risk factors, management, and outcomes. One man and two women (aged 74-86 years) demonstrated acute onset of HCHB, lasting for at least several [...] Read more.
We examined pathogenesis and clinical features of three hemichorea-hemiballism (HCHB) cases. We studied their age, magnetic resonance imaging results, vascular risk factors, management, and outcomes. One man and two women (aged 74-86 years) demonstrated acute onset of HCHB, lasting for at least several months. Patients had one or more vascular risk factors, including hypertension and diabetes. All patients presented subacute or old infarction in the basal ganglia with contralateral symptoms. We administered clonazepam (0.5-1 mg/day), haloperidol (0.375-0.75 mg/day), or both as necessary and observed symptom-control. Vascular lesions in the basal ganglia were a contributing factor. Symptoms were controlled using pharmacotherapy with gamma-aminobutyric acid-agonist (clonazepam) or anti-dopaminergic (haloperidol) medication. Full article
1 pages, 534 KiB  
Article
Bilateral Hemiballism-Hemichorea Presenting in a Diabetes Taiwanese Woman
by Chih Ming Lin and Chi-Kuang Liu
Neurol. Int. 2014, 6(3), 5519; https://doi.org/10.4081/ni.2014.5519 - 8 Aug 2014
Cited by 3 | Viewed by 496
Abstract
Hemiballism-hemichorea (HB-HC) is a hyperkinetic disorder characterized by continuous involuntary movements of the extremities. It could be associated with non-insulin dependent diabetes mellitus. A very few cases of bilateral HB-HC have been reported until today. We describe here the case of a Taiwanese [...] Read more.
Hemiballism-hemichorea (HB-HC) is a hyperkinetic disorder characterized by continuous involuntary movements of the extremities. It could be associated with non-insulin dependent diabetes mellitus. A very few cases of bilateral HB-HC have been reported until today. We describe here the case of a Taiwanese woman (85 years old) presenting with bilateral HB-HC and diabetes mellitus. Full article
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