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Hyperglycemia-induced unilateral basal ganglion lesions with and without hemichorea A PET study

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Abstract

Hyperglycemia-induced unilateral basal ganglion lesions occur mostly in Asian patients. A signal abnormality in the basal ganglion region is evident on these patients’ neuroimaging. Despite characteristic imaging findings and clinical manifestations, the underlying mechanism is still unclear. To clarify the underlying pathophysiology of unilateral basal ganglion lesions, we examined the [18F]-fluorodeoxyglucose (FDG) positron emission tomography (PET) findings in 3 patients with hyperglycemia. The PET studies were performed at 3 weeks, 5 weeks, and 7 months after clinical onset. The markedly reduced rates of cerebral glucose metabolism in the corresponding lesions on T1-weighted magnetic resonance images provided direct evidence of regional metabolic failure. We suggest that the metabolic derangements associated with hyperglycemia and vascular insufficiency contribute to regional metabolic failure in patients with poorly controlled diabetes mellitus.

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References

  1. Aiegler D, Langen KJ, Herzog H, Kuwert T, Muhlen H, Feinendegen LE, Gries FA (1994) Cerebral glucose metabolism in type 1 diabetic patients. Diabet Med 11:205–209

    Google Scholar 

  2. Auer RN, Benveniste H (1997) Hypoxia and related conditions. In: Graham DI, Lantos PL (eds) Greenfield’s neuropathology. London: Edward Arnold, pp 263–314

  3. Fujioka M, Taoka T, Hiramatsu KI, Sakaguchi S, Sasaki T (1999) Delayed ischemic hyperintensity on T1-weighted MRI in the caudoputamen and cerebral cortex of humans after spectacular shrinking deficit. Stroke 30:1038–1042

    Google Scholar 

  4. Fujioka M, Taoka T, Matsuo Y, Mishima K, Ogoshi K, Kondo Y, Tsuda M, Fujiwara M, Asano T, Sakaki T, Miyasaki A, Park D, Siesjö BK (2003) Magnetic resonance imaging shows delayed ischemic striatal neurodegeneration. Ann Neurol 54:732-747

    Google Scholar 

  5. Grill V, Gutniak M, Bjorkman O, Lindqvist M, Stone-Elander S, Seitx RJ, Blomqvist G, Reichard P, Widen L (1990) Cerebral blood flow and substrate utilization in insulin-treated diabetic subjects. Am J Physiol 258:E813–E820

    CAS  PubMed  Google Scholar 

  6. Henkelman RM, Watts JF, Kucharczyk W (1991) High signal intensity in MR images of calcified brain tissue. Radiology 179:199–206

    CAS  PubMed  Google Scholar 

  7. Inoue E, Hori S, Narumi Y (1991) Portal-systemic encephalopathy: presence of basal ganglia lesions with high signal intensity of MR images. Radiology 179:551–555

    Google Scholar 

  8. Kjos BO, Brant-Zawadzki M, Young RG (1983) Early CT findings of global central nervous system hypoperfusion. Am J Neuroradiol 141:1227–1232

    Google Scholar 

  9. Lee MS, Marsden CD (1994) Neurological sequelae following carbon monoxide poisoning, clinical course and outcome according to clinical types and brain computed tomography scan findings. Mov Disord 9:550–558

    Google Scholar 

  10. Lin JJ, Chang MK, Lee CC, Tsao WL (1995) Hemiballism-hemichorea: clinical study in 23 Chinese patients. Zhonghua Yi Xue Za Zhi (Taipei) 55:156–162

    Google Scholar 

  11. Lin JJ, Lin GY, Shih C, Shen WC (2001) Presentation of striatal hyperintensity on T1-weighted MRI in patients with hemiballism-hemichorea caused by non-ketotic hyperglycemia: report of seven new cases and a review of literature. J Neurol 248:750–755

    Google Scholar 

  12. Oh SH, Lee KY, Im JK, Lee MS (2002) Chorea associated with non-ketotic hyperglycemia and hyperintensity basal ganglia lesion on T1-weighted brain MRI study: a meta-analysis of 53 cases including four present cases. J Neurol Sci 200:7–62

    Google Scholar 

  13. Ohara S, Nakagawa S, Tabata K, Hashimoto T (2001) Hemiballism with hyperglycemia and striatal T1-MRI hyperintensity: an autopsy report. Mov Disord 16:521–525

    Google Scholar 

  14. Shan DE, Ho DMT, Chang C, Pan HC, Teng MM (1998) Hemichoreahemiballism: an explanation for MR signal changes. Am J Neuroradiol 19:863–870

    Google Scholar 

  15. Shimomura T, Nozaki Y, Tamura K (1995) Hemichorea-hemiballism associated with nonketotic hyperglycemia and presenting with unilateral hyperintensity of the putamen on MRI T1-weighted images–a case report. No To Shinkei 47:557–561

    Google Scholar 

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Correspondence to Han-Cheng Wang MD.

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Hsu, J.L., Wang, HC. & Hsu, WC. Hyperglycemia-induced unilateral basal ganglion lesions with and without hemichorea A PET study. J Neurol 251, 1486–1490 (2004). https://doi.org/10.1007/s00415-004-0571-4

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  • DOI: https://doi.org/10.1007/s00415-004-0571-4

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