A few thoughts on diabetic striatopathy – case report and short review

Abstract

Diabetic striatopathy is an uncommon complication of diabetes mellitus, usually characterized by hemichorea-hemiballismus with T1-high signal intensities involving the contralateral striatum. We present the case of an 81 years-old woman with poorly controlled type 2 diabetes mellitus, who was rushed to the hospital for acute-onset right-sided hemiparesis, somnolence and aphasia. Blood analysis revealed hyperglycemia (412 mg/dl) and raised level of glycated hemoglobin (14.5%), while head CT examination showed a spontaneous hyperdensity involving the left caudate and lenticular nuclei, with no edema. Brain MRI was also performed and highlighted T1-hyperintensities at the level of the same structures, with no diffusion restriction. The patient improved significantly under adjustment of insulin therapy. Based on these observations, a diagnosis of diabetic striatopathy was established. We present a short review of the literature regarding this condition and its main characteristics.

Keywords

• diabetes mellitus
• hyperglycemic encephalopathy
• striatopathy
• hemichoreahemiballismus
• insulin therapy