Acute bilateral basal ganglia lesions in patients with diabetic uremia: an FDG-PET study.
OBJECTIVE
Head CT and MRI show characteristic changes in the syndrome of acute bilateral basal ganglia lesions in patients with diabetic uremia. However, they do not provide further insight into the underlying pathophysiology. To further clarify the biologic mechanism of the syndrome, F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) was used in 2 patients.


METHODS
PET studies were performed in 2 diabetic uremic patients with acute movement disorders. The cerebral glucose metabolic rates in these 2 patients were compared with 11 normal age-matched controls. The images were further analyzed with statistical parametric mapping to identify regions of significant metabolic abnormality.


RESULTS
The cases showed markedly reduced glucose metabolism in the bilateral basal ganglia, especially in the bilateral putamens, where the glucose uptake was nearly absent.


CONCLUSIONS
FDG-PET correlates better with the clinical conditions and provides more pathophysiological information than head CT or MRI scans in bilateral basal ganglia lesions in patients with diabetic uremia. We propose that acute exacerbation of a long-term glucose utilization failure in the basal ganglia cells produced these lesions.
Wang
Han-Cheng
HC
School of Medicine, Fu-Jen Catholic University, Taipei, Taiwan.
Hsu
Jung Lung
JL
Shen
Yeh-You
YY
D000208:Acute Disease; D000368:Aged; D001479:Basal Ganglia / Q000378:metabolism; D001480:Basal Ganglia Diseases / Q000150:complications / Q000000981:diagnostic imaging* / Q000378:metabolism; D003928:Diabetic Nephropathies / Q000150:complications*; D005260:Female; D019788:Fluorodeoxyglucose F18; D005947:Glucose / Q000378:metabolism; D006801:Humans; D008297:Male; D019275:Radiopharmaceuticals; D014055:Tomography, Emission-Computed; D014057:Tomography, X-Ray Computed; D014511:Uremia / Q000150:complications*
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D005947:Glucose