Vascular contribution to hyperglycaemia-induced hemichorea

A case of hemichorea associated with nonketotic hyperglycaemia: A new magnetic resonance spectroscopy (MRS) finding and possible future implications

BACKGROUND

Diabetic Striatopathy (DS) is a rare complication of a poor-controlled Diabetes Mellitus consisting of sudden onset of movement disorders. To date, there is still poor knowledge about the pathogenesis.

CASE

We describe a 79 year old men affected by sudden onset hemichoreic movements whose cause was a non-ketotic hyperglycaemia diagnosed despite the normal blood glucose levels thanks to brain CT and magnetic resonance imaging. Then, we introduce a new magnetic resonance spectroscopy (MRS) finding never described until today which allowed us to produce a new pathogenetic theory of a phenomenon still without definitive explanations.

LITERATURE REVIEW

We performed a review of DS cases using the Medline database and we extracted main data regarding imaging findings.

CONCLUSIONS

Thanks to our MRS we show new imaging findings never described until today, with a new pathogenetic explanation, since all the causative hypotheses produced during the past years have never found evidence.

Coexisting Moyamoya Syndrome and Type 1 Diabetes Mellitus: A Case Report and Review of the Literature

Moyamoya disease (MMD) is an incompletely understood malady that affects many age groups, primarily in a bimodal age distribution. We present a patient with the association of type 1 diabetes mellitus (type 1 DM) and MMD followed by a review of the existing literature. We found five papers that describe this association, in the form of one case report, one case series, and three retrospective reviews. Despite a poor understanding of the underlying pathophysiology, a clear association between autoimmune conditions and MMD appears to exist. Clinicians who manage such patients ought to be vigilant and have a high index of suspicion when young patients with type 1 DM present with new onset of neurological symptoms.