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Putaminal Changes before the Onset of Clinical Symptoms in Diabetic Hemichorea-hemiballism

Nobuhito Nakajima, Masayuki Ueda, Hiroshi Nagayama, Yasuo Katayama
2014 Internal medicine (Tokyo. 1992)  
An 81-year-old woman with poorly controlled diabetes mellitus was hospitalized due to hemichoreahemiballism. A radiological examination revealed typical putaminal changes of diabetic hemichoreahemiballism (DHC-HB). Interestingly, brain computed tomography, performed before symptom onset, disclosed a hyperdense lesion in the left basal ganglia, indicating persistent basal ganglia impairment, even before the onset of symptoms, under sustained hyperglycemia. Additionally, an increase in the
more » ... rease in the cerebrospinal fluid level of homovanillic acid was related to the symptom appearance of DHC-HB. Pronounced potential basal ganglia impairment under hyperglycemia and central dopaminergic hyperactivity was important for the development of DHC-HB in this patient.
doi:10.2169/internalmedicine.53.1359 pmid:24583441 fatcat:4sykfjxfyjentd3b5gb2bytqqa