Hemichorea-Hemiballismus Due to Non-Ketotic Hyperglycemia

Year 2008, Volume: 2 Issue: 1, 264 - 268, 23.03.2008

Hayat Güven

Abstract

Non-ketotic hyperglycemia is a rare cause of hemichorea-hemiballismus. Hemichorea-hemiballismus associated with non-ketotic hyperglycemia, is usually seen in old and diabetic women who have unregulated glucose regimen. The disorder has characteristic cerebral imaging findings and prognosis is generally good. The pathophysiology of the disorder and the nature of the findings seen in imaging studies are not clear yet. While alterations of neurotransmitters due to metabolic derangement and cerebral ischemia are considered to be responsible in pathogenesis; calcifications, petechial hemorragies, myelinolysis and presence of abundant gemistocytes have been suggested as possible mechanisms of the lesions seen in imaging studies. In this paper, we describe a diabetic 80 year old woman who presented with right hemichorea-hemiballismus associated with non-ketotic hyperglycemia. There was a hyperintense lesion at contralateral striatum on T1 weighted magnetic resonance images and the involuntary movements of the patient didn’t respond to the medical theraphy.

Keywords

Chorea; hyperglycemia;, magnetic, resonance imaging

Non-Ketotik Hiperglisemiye Bağlı Hemikore-Hemiballismus

Abstract

Non-ketotik hiperglisemi, hemikore-hemiballismusun nadir bir nedenidir. Nonketotik hiperglisemiye bağlı hemikore-hemiballismus, genellikle yaşlı ve kan şekeri regüle olmayan diabetik kadınlarda görülür. Karakteristik görüntüleme bulgularına sahiptir ve sıklıkla iyi prognozludur. Hastalığın patofizyolojisi ve görüntüleme çalışmalarındaki bulguların doğası henüz tam aydınlatılamamıştır. Metabolik yetmezlik sonucunda gelişen nörotransmitter değişiklikleri ve serebral iskemi hastalığın patogenezinde sorumlu tutulurken; görüntüleme çalışmalarında saptanan lezyonların kalsifikasyonlardan, peteşiyal hemorajilerden, myelinolizisden veya abondan gemistositlerin varlığından kaynaklanabileceği ileri sürülmüştür. Bu makalede; sağ hemikore-hemiballismus ile başvuran ve etiyolojisinde non-ketotik hiperglisemi saptanan 80 yaşında diabetik bir kadın hasta sunulmuştur. Hastanın Tl ağırlıklı magnetik rezonans görüntülemesinde kontrlateral striatumda hiperintens lezyon belirlenmiş ve istemsiz hareketler medikal tedaviye direnç göstermiştir.

Keywords

Kore; hiperglisemi; manyetik rezonans görüntüleme, mr, kore,

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