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[Hemichorea caused by striatal infarct in a young type 1 diabetic patient]
M Bellassoued1, C Mhiri, C Triki
1Service d'endocrinologie, CHU Hédi Chaker, Sfax, Tunisie.
Insights
Movement disorders like hemichorea are rare in diabetes mellitus. This case highlights a young man with type 1 diabetes experiencing hemichorea due to a striatal infarct, suggesting microvascular complications.
Area of Science:
- Neurology
- Endocrinology
- Diabetology
Background:
- Movement disorders are uncommon complications of diabetes mellitus.
- Type 2 diabetes is more frequently associated with hemichorea/hemiballism, often due to non-ketotic hyperglycemia.
- Striatal infarcts are a rare cause of these movement disorders in diabetic patients.
Observation:
- A 26-year-old male with a 13-year history of type 1 diabetes presented with right-sided hemichorea.
- Brain imaging revealed an infarction in the head of the caudate nucleus and anterior putamen.
- The patient exhibited microangiopathy in the retina, kidneys, and peripheral nerves.
Findings:
- The findings suggest lenticulo-striatal artery involvement secondary to diabetic microangiopathy.
- This case presents a rare instance of striatal infarction causing hemichorea in a young patient with type 1 diabetes.
- The etiology differs from typical cases seen in older type 2 diabetes patients.
Implications:
- This case expands the understanding of potential neurological complications in type 1 diabetes.
- It underscores the importance of considering vascular events in diabetic patients presenting with movement disorders.
- Further research may elucidate the specific mechanisms linking type 1 diabetes, microangiopathy, and striatal infarcts.
Abstract:
Movement disorders such as chorea and ballism rarely occur in diabetes mellitus. We report the case of 26-year-old man with a 13-year-history of type 1 diabetes mellitus. He presented with a right side hemichorea. Brain CT-scan and MRI showed an infarction of the head of the caudate nucleus and the anterior part of the putamen. Presence of microangiopathy affecting retina, kidneys and peripheral nerves suggest a similar involvement of the lenticulo-striatal arteries. Hemichorea and hemiballism usually occur in older patients presenting type 2 diabetes mellitus. Non-ketotic hyperglycaemia is the common cause in such situation. Striatal infarct, as seen in our patient, is rarely reported.