Blood brain barrier destruction in hyperglycemic chorea in a patient with poorly controlled diabetes.
A case of hemichorea in a patient with poorly controlled diabetes is reported. T1-weighted magnetic resonance imaging (MRI) showed an unusual homogeneous high-intensity area in the corpus striatum. Of interest in the case was the fact that the globus pallidus, which was enhanced with gadolinium at the onset of hemichorea, showed homogeneous high-intensity on a subsequent T1-weighted image. This indicated that blood brain barrier destruction preceded the signal intensity change in the basal ganglia. As far as the authors could determine, this is the first reported case showing such enhancement during the course of diabetic hemichorea.
Iwata
A
A
Department of Neurology, Graduate School of Medicine, University of Tokyo, Japan. iwata-tky@umin.ac.jp
Koike
F
F
Arasaki
K
K
Tamaki
M
M
D018726:Anti-Dyskinesia Agents / Q000627:therapeutic use; D001479:Basal Ganglia / Q000000981:diagnostic imaging / Q000473:pathology; D001812:Blood-Brain Barrier; D002819:Chorea / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology*; D003342:Corpus Striatum / Q000098:blood supply / Q000473:pathology; D003545:Cysteine / Q000031:analogs & derivatives; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000097:blood; D019786:Gadolinium DTPA; D005917:Globus Pallidus / Q000098:blood supply / Q000473:pathology; D006220:Haloperidol / Q000627:therapeutic use; D006801:Humans; D006943:Hyperglycemia / Q000150:complications / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; D013976:Tiapamil Hydrochloride / Q000627:therapeutic use; D015899:Tomography, Emission-Computed, Single-Photon
D018726:Anti-Dyskinesia Agents; D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; C059659:technetium Tc 99m bicisate; D006220:Haloperidol; D019786:Gadolinium DTPA; D003545:Cysteine; D013976:Tiapamil Hydrochloride