非酮症高血糖偏侧舞蹈症5例临床特点分析

Clinical features of hemichorea associated with nonketotic hyperglycemia: An analysis of 5 cases

由糖尿病引起的非酮症高血糖偏侧舞蹈症(HC-NH)临床较为罕见。该文报道了5例HC-NH患者,均为老年女性,平均年龄70岁,有糖尿病史,发病至入院时间4~30 d,糖化血红蛋白7.6%~17.5%。所有患者均自一侧肢体起病;1例患者头颅CT表现为发病对侧基底节区稍高密度影;3例患者MRI提示基底节区(单侧或双侧基底节)高信号,病灶呈团片状或斑点状;1例无MRI异常表现。所有患者在降糖或增加抗多巴胺能类药物治疗后症状缓解,预后良好。

Hemichorea associated with nonketotic hyperglycemia(HC-NH) caused by diabetes is relatively rare in clinical practice.This article reported 5 cases of HC-NH patients.All patients were elderly women,with an average age of 70 years and a history of diabetes.The time from disease onset to admission ranged from 4 to 30 days,and the level of glycosylated hemoglobin ranged from 7.6% to 17.5%.All patients had disease onset from one limb;1 patient had slightly high-density shadow in the contralateral basal ganglia area on head CT scan;3 patients’ showed high signal intensity in the basal ganglia(unilateral or bilateral) on MRI,and the lesions were mass flakes or spots;1 patient had no abnormal manifestation on MRI.All patients achieved the relief of symptoms and had a good prognosis after hypoglycemic therapy or the addition of anti-dopaminergic drugs.