HYPERGLYCAEMIC HEMIBALLISMUS: IMPLICATIONS FROM CONNECTIVITY ANALYSIS FOR COGNITIVE IMPAIRMENTS.

Area of Science:

• Neurology
• Endocrinology
• Radiology

Background:

• Hyperglycemia-induced movement disorders, particularly hemiballism, are uncommon neurological conditions.
• The typical presentation involves hemiballism, contralateral striatal T1-hyperintense lesions on MRI, and non-ketotic hyperglycemia.
• Acantocytosis can be a co-occurring finding in some patients.

Observation:

• This report details a patient with untreated diabetes experiencing acute hemiballism.
• Magnetic resonance imaging (MRI) showed T1 hyperintensity in the caudate nucleus and anterior putamen.
• The patient also presented with acanthocytosis.

Findings:

• The study discusses the potential pathomechanisms, including microhemorrhages, extensive mineralization, and gemistocytic astrocytosis contributing to imaging findings.
• The striatal lesion exhibited significant connectivity with the frontal cortex.
• Impairment in phonemic verbal fluency, indicative of frontal executive dysfunction, was observed.

Implications:

• This case deepens the understanding of hyperglycaemia's neurological impact.
• It underscores the importance of considering metabolic disturbances in movement disorder diagnosis.
• Further research into the neurobiological underpinnings of hyperglycaemia-related brain changes is warranted.