糖尿病性偏侧舞蹈症临床分析

目的探讨糖尿病性偏侧舞蹈症的临床表现、发病机制及影像学表现。方法分析了2例糖尿病性偏侧舞蹈症患者的临床表现、治疗经过及影像改变，并学习相关文献。结果2例糖尿病患者均未经过系统的降血糖治疗，且均为非酮症高血糖患者。2例患者均为急性起病，出现一侧肢体舞蹈样运动，睡眠时消失，早期CT表现为患肢对侧侧尾状核、壳核和（或）苍白球高密度影，一个月左右减弱或消失。MRI则表现为病灶区T1为高信号，T2为低信号或高信号，边界清晰，无水肿征象。结论糖尿病性偏侧舞蹈症多见于未糸统控制血糖的糖尿病患者，发病部位以纹状体为主，CT早期表现为高密度影，易与脑出血相混淆，MRIT1像为高信号，T2像为低信号或高信号认识该疾病可以使糖尿病患者得到及时有效的治疗；防止误诊误治的发生。

Hemichorea associated with diabetic hyperglycemia

Objective To investigate the clinical manifestation, pathogenesis and imaging features of hemichorea associated with hyperglycemia in primary diabetes mellitus （DM）. Methods Analyze the clinical manifestations, the neuroimaging features and the treatment of the two patients with hemichorea induced by hy- perglycaemia in primary DM, and review the literatures about this disease. Results All of the two cases had a long history of uncontrolled diabetes, among whom, two were non-ketotic hyperglycemic patients, both of them had an acute onset hemichorea which was almost continuous during awakeness and ceased during sleep. The ear- ly CT findings in this disorder were high density in the caudate nucleus,putamen and/or globus pallidus on the side contralateral to the involved hmbs, but showed decreased attenuation or completetly resolved in about a month. T1 -weighted MR images in all cases showed high-signal intensities, while the T2-weighted images showed low-signal or high-signal intensities without edema. Conclusion Hemichorea induced by hyperglycemia often happens in the patients with poorly controlled DM. In the major affected region-corpora striata, CT shows hyper- dense lesions, confuses easily with cerebral hemorrhage. T1-weighted MR images show hyperntense lesions and T~-weighted images showed low-signal or high-signal intensities. Knew this disease may enable diabetes patient to obtain the prompt effective treatment, prevented the error diagnostic governs by mistake occurrence.