Hemichorea-hemiballismus associated with nonketotic hyperglycemia: a possible role of inflammation.
Three cases of hemichorea-hemiballismus (HC-HB) associated with nonketotic hyperglycemia were reported. Of them two patients presented as HC-HB and the remaining one as generalized chorea-ballismus (CB). Brain MRI showed characteristic T1-weighted high-intensity lesions in the contralateral or bilateral striatum without edema or mass effect. They all had a prior history of respiratory or urinary infection. Cerebrospinal fluid test in two patients showed an elevation of protein concentration with normal cell and an increased IgG content and elevated IgG index or 24 h IgG intrathecal synthesis rate. These results suggested that inflammation within the central nervous system may participate in the pathogenesis of chorea and ballismus induced by NKH.
Wang
Jing-hua
JH
Department of Health Care Center, 2nd Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, PR China.
Wu
Tao
T
Deng
Ben-qiang
BQ
Zhang
Yong-wei
YW
Zhang
Ping
P
Wang
Zhong-kui
ZK
D000369:Aged, 80 and over; D018726:Anti-Dyskinesia Agents / Q000627:therapeutic use; D020274:Autoimmune Diseases of the Nervous System / Q000209:etiology; D002819:Chorea / Q000134:cerebrospinal fluid / Q000188:drug therapy / Q000209:etiology* / Q000276:immunology / Q000503:physiopathology; D003342:Corpus Striatum / Q000473:pathology; D020820:Dyskinesias / Q000134:cerebrospinal fluid / Q000188:drug therapy / Q000209:etiology* / Q000276:immunology / Q000503:physiopathology; D005260:Female; D005917:Globus Pallidus / Q000473:pathology; D006220:Haloperidol / Q000627:therapeutic use; D006801:Humans; D006943:Hyperglycemia / Q000134:cerebrospinal fluid / Q000150:complications*; D007136:Immunoglobulins / Q000134:cerebrospinal fluid; D007239:Infections / Q000150:complications* / Q000276:immunology; D007249:Inflammation / Q000150:complications* / Q000276:immunology / Q000503:physiopathology; D008279:Magnetic Resonance Imaging; D009123:Muscle Hypotonia / Q000209:etiology; D011693:Purpura / Q000209:etiology / Q000473:pathology; D011699:Putamen / Q000473:pathology
D018726:Anti-Dyskinesia Agents; D007136:Immunoglobulins; D006220:Haloperidol