Movement disorders in patients with diabetes mellitus

Jagota, Priya; Bhidayasiri, Roongroj; Lang, Anthony E.

doi:10.1016/j.jns.2011.10.033

Cited by 36 publications

(50 citation statements)

References 74 publications

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“…In typical cases, cerebral MRI shows hyperintense signal of the putamen, in T1-weighted images, probably reflecting the accumulation of manganese in gemistocytes (ie, astrocytes with large protein content found during acute brain injury). 7,8 The rare histopathological studies of autopsied adults revealed the presence of gliosis, the accumulation of gemistocytes and a localized loss of neurons, without evidence of hemorrhage or infarct. 9 Similar studies in the pediatric population are wanting, and specific pathologic mechanisms in that age group remain to be understood.…”

Section: Figurementioning

confidence: 99%

Diabetic Striatopathy in Childhood: A Case Report

et al. 2016

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Diabetic striatopathy is a well-known complication of diabetes in adults. To our knowledge, only 2 cases have been reported in children. We here report the case of a teenager in whom diabetic striatopathy was revealed by the subacute appearance of hemichorea-hemiballism in the context of weight loss, polyuria, and polydipsia. Glycemia control allowed rapid clinical recovery despite established striatal lesions documented on MRI. We also discuss current hypotheses about pathophysiological processes underlying this entity

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Section: Figurementioning

confidence: 99%

Diabetic Striatopathy in Childhood: A Case Report

et al. 2016

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“…[8][9][10] Similar findings may occur in hypoglycemic patients, who can additionally present with chorea, ataxia, paresis, aphasia, and coma. 8,[11][12][13] Neonates with hypoglycemia may show a constellation of symptoms that are usually nonspecific and include poor feeding, lip smacking, eye rolling, and seizures. 4,14 In emergency settings, it is not uncommon for these symptoms be diagnosed and treated initially as stroke.…”

mentioning

confidence: 86%

“…17,19 HC-HB in association with hyperglycemia is well recognized. 8 It has been predominantly reported in elderly patients with NIDDM and is more common in Asians. 17,18,20 Patients present with acute onset of HC-HB, which is often unilateral but may be generalized.…”

Section: Hemichorea-hemiballismus In Non-ketotic Hyperglycemiamentioning

confidence: 99%

“…17,18,20 Patients present with acute onset of HC-HB, which is often unilateral but may be generalized. 8,20 The abnormal movements may be continuous or intermittent and disappear during sleep. 8,21 Laboratory findings confirm poorly controlled diabetes with raised blood glucose and HbA1C levels and absence of blood and urinary ketones.…”

Section: Hemichorea-hemiballismus In Non-ketotic Hyperglycemiamentioning

confidence: 99%

“…8,20 The abnormal movements may be continuous or intermittent and disappear during sleep. 8,21 Laboratory findings confirm poorly controlled diabetes with raised blood glucose and HbA1C levels and absence of blood and urinary ketones. The serum osmolality is often elevated.…”

Section: Hemichorea-hemiballismus In Non-ketotic Hyperglycemiamentioning

confidence: 99%

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Neuroimaging in Patients with Abnormal Blood Glucose Levels

Bathla

Policeni

Agarwal

2013

American Journal of Neuroradiology

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SUMMARY:Smooth neuronal functioning requires an uninterrupted supply of energy that is provided by glucose under normal physiologic conditions. Significant variations in plasma glucose levels, be it hypoglycemia or hyperglycemia, can present with myriad clinical manifestations and may mimic stroke. At times, the diagnosis is either not apparent or not clinically suspected. Imaging can suggest the diagnosis in unsuspected cases and can help in the assessment of the extent of neuronal damage in known cases, making it vital for the neuroradiologist to be aware of both common and atypical neuroimaging findings in hypoglycemia and hyperglycemia.ABBREVIATIONS: GABA ϭ gamma aminobutyric acid; HC-HB ϭ hemichorea-hemiballismus; NIDDM ϭ non-insulin-dependent diabetes mellitus; NKHG ϭ non-

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A case of hemichorea‐hemiballism presenting in association with diabetic ketoacidosis

2017

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Movement disorders are a rare but recognised manifestation of non‐ketotic hyperglycaemic episodes on a background of poorly‐controlled diabetes mellitus. The literature is otherwise sparse when it comes to an association between hemichorea‐hemiballism and diabetic ketoacidosis (DKA). A patient with no past medical history of note was admitted with a sudden‐onset involuntary movement disorder and was found to be in DKA during her inpatient stay. There was a delay in diagnosis and management as all efforts pointed in the direction of diagnosing the cause of the sudden‐onset hemichorea‐hemiballism as a potential cerebrovascular event. The movements subsided with treatment of the ketoacidosis and with the addition of tetrabenazine. Imaging revealed a hyperdensity of the left basal ganglia consistent with a metabolic cause and not an ischaemic event. Although the pathophysiology of movement disorders in diabetes is still unclear, this case highlights the importance in maintaining a wide list of differentials when faced with an atypical presentation of hemichorea‐hemiballism, especially as DKA is a reversible emergency with high mortality rates if left untreated. Hemichorea‐hemiballism as a consequence of DKA seems to be a multifactorial phenomenon. In this case, it began with non‐ketotic hyperglycaemia and evolved into ketoacidosis. Confounding factors precipitating this included infection, and delayed diagnosis and management. Copyright © 2017 John Wiley & Sons.

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Movement disorders in patients with diabetes mellitus

Cited by 36 publications

References 74 publications

Diabetic Striatopathy in Childhood: A Case Report

Diabetic Striatopathy in Childhood: A Case Report

Neuroimaging in Patients with Abnormal Blood Glucose Levels

A case of hemichorea‐hemiballism presenting in association with diabetic ketoacidosis

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