糖尿病性非酮症偏侧舞蹈症一例

A Case of Diabetic Non-ketotic Hemiplegic Disease

目的为提高对糖尿病性非酮症偏身舞蹈症的认识。方法分析1例糖尿病性非酮症偏身舞蹈症患者的病史、临床表现、影像学检查及诊疗经过,结合糖尿病非酮症偏身舞蹈症的相关文献进行进一步探讨。结果糖尿病性非酮症偏身舞蹈症是一种建立在糖尿病并发症基础上的特殊类型的脑部疾病,易与精神障碍、癫痫等疾病混淆,常表现为非酮症性高血糖,单侧或双侧肢体的不自主运动,MRI或CT提示对侧基底节区T1高密度影,尽早明确诊断,积极控制血糖,改善脑功能有助于后期康复。结论糖尿病患者血糖控制不理想,或未知血糖异常的患者,并发锥体外系症状,应考虑糖尿病性舞蹈症,及早干预治疗。及时诊断、及早控制血糖并给予氟哌啶醇等多巴胺受体拮抗剂应用后预后良好,如单纯控制血糖而不使用氟哌啶醇等药物,患者症状亦能逐渐改善,控制血糖是治疗该病的关键。

Objective This study is to improve the understanding of diabetic non-ketotic partial chorea.Methods Analysis of a case of diabetic non-ketotic ecstasy of the disease,clinical manifestations,imaging examination and diagnosis and treatment,combined with diabetes non-ketone literature on the phenomenon of eccentric chorea is further explored.Results Diabetic non-ketotic ecstasy is a special type of brain disease based on diabetic complications,which is easily confused with mental disorders,epilepsy and other diseases.Often manifested as non-ketotic hyperglycemia,involuntary movement of unilateral or bilateral limbs,MRI or CT suggesting high density of T1 in the contralateral basal ganglia,early diagnosis,active control of blood glucose,and improvement of brain function rehabilitation.Conclusion Patients with unsatisfactory glycemic control in diabetic patients,or patients with abnormal blood glucose abnormalities,with extrapyramidal symptoms should consider diabetic chorea,early intervention,timely diagnosis,early control of blood glucose and administration of dopamine receptors such as haloperidol.After the application of the antagonist,the prognosis is good.For example,if the blood glucose is not controlled and the drug such as haloperidol is used,the symptoms of the patient can be gradually improved and controlling blood glucose is the key to treating the disease.