Striatopathy and stroke in diabetes: insights from two cases and literature review

There is varied phenotypic presentations of diabetic striatopathy (DS), traditionally characterized by hyperglycemia, acute-onset choreoballism, and/or specific neuroimaging findings. Emerging evidence indicates that DS may coexist with stroke, complicating diagnosis and treatment, as both conditions can influence each other's progression.

Two cases of DS with concurrent stroke at a single center and 15 similar previously published cases have been analyzed. The detailed evaluation included demographics, symptomatology, glycemic data, neuroimaging, management, and prognosis. Appropriate descriptive statistical analyses have been performed.

This study demonstrates how stroke symptoms and involuntary movements can coexist and interact. Four distinct phenotypes of the "stroke-striatopathy model" have been identified. It raises the possibility of patients with DS being at risk of imminent cerebrovascular events rather than being a mere bystander.

The study underscores the necessity for ongoing monitoring of DS patients for potential cerebrovascular incidents and the implications for clinical management and long-term patient outcomes.