Hemichorea in Two Poorly Controlled Diabetic Patients

Abstract

We report two diabetic patients with hemichorea. In case 1, a 58-year-old-man with a 7-year history of diabetes admitted to our hospital because of hyperglycemia. On admission, his plasma glucose and HbAlc level were 705mg/dl and 14.8%, respectively, and he had diabetic triopathies. After admission, his diabetes was well controlled but left-sided hemichorea appeared suddenly. CT examination revealed a high density area in the right putamen, and T 1-weighted MR images showed a high intensity in the right putamen and caudate nucleus, which diminished 3 months after the onset of hemichorea in association with the improvement of choreiform movements. In case 2, a 46-year-man with hyperglycemia and hypertension was admitted to a hospital because of abrupt onset of right-sided hemichorea. Three weeks later, he visited our hospital because his choreiform movements remained unchanged. His diabetes and hypertension were well controlled, but he had proteinuria, fundus hupertonicus and neuropathy. After administration of haloperidol, his choreiform movements disappered. Early CT examination showed a high density in the left putamen, and T 1-weighted MR images also revealed a high intensity in this area, which disappeared 5 months after the onset of choreiform movements. We consider these findings suggestive of pathomechanisms of hemichorea including ischemia and imbalance of neurotransmitters in the putamen and caudate nucleus. © 1999, THE JAPAN DIABETES SOCIETY. All rights reserved.