title: Glycemic and vascular choreoballism as main causes of secondary choreoballism involving the putamen.
abstract: The putamen is frequently involved in cases of secondary choreoballism (CB). To date, no study has investigated clinical features of secondary CB such as vascular CB (vCB) and glycemic CB (gCB) in view of putaminal involvement.
  
  
  
  Cases of CB with putaminal lesions from our hospital were identified in hospital records. Historical cases were obtained from the MEDLINE database. Cases of gCB are defined as those with CB, diabetes mellitus and high signal intensities (HSIs) in the putamen on T1 weighted imaging (T1WI). Cases of vCB are identified among those with CB and stroke involving the putamen.
  
  
  
  A total of 284 cases (in-hospital cases, 11 gCB and 3 vCB; historical cases, 225 gCB and 45 vCB) were included after excluding 23 glycemic cases without HSIs on T1WI and 53 cases with non-glycemic etiologies. Persistence of CB was longer than one month in 84 cases (gCB, 36.9%, and vCB, 63.0%). Extra-putaminal lesions occurred more frequently in vCB (71.1%) than gCB (50.7%). Age, cerebrovascular etiology and extra-putaminal lesions were found to be significant predictors for persistence of CB one month after onset. Female gender and extra-putaminal lesions were significant predictors for persistence of CB one year after onset.
  
  
  
  gCB was the primary common cause of secondary CB involving the putamen. Older age, female gender, vascular etiologies and extensive lesions (putaminal and extra-putaminal) were significant predictors of CB persistence.
authors.affiliation: Department of Neurology, College of Medicine, Kyung Hee University, Seoul, Republic of Korea.
authors.forename: Dokyung
authors.initials: D
authors.lastname: Lee
authors.affiliation: Department of Neurology, College of Medicine, Kyung Hee University, Seoul, Republic of Korea.
authors.forename: Young Nam
authors.initials: YN
authors.lastname: Kwon
authors.affiliation: Department of Neurology, College of Medicine, Kyung Hee University, Seoul, Republic of Korea.
authors.forename: Sang Hyun
authors.initials: SH
authors.lastname: Shon
authors.affiliation: Department of Pathology, College of Medicine, Kyung Hee University, Seoul, Republic of Korea.
authors.forename: Ju Hie
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Department of Neurology, College of Medicine, Kyung Hee University, Seoul, Republic of Korea. Electronic address: ricash@hanmail.net.
authors.forename: Tae-Beom
authors.initials: TB
authors.lastname: Ahn
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000378:metabolism; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D019578:Multiple System Atrophy / Q000175:diagnosis* / Q000473:pathology*; D011699:Putamen / Q000378:metabolism / Q000473:pathology*; D012737:Sex Factors; D020521:Stroke / Q000175:diagnosis / Q000378:metabolism*
chemical_list: D001786:Blood Glucose
keywords: Cerebrovascular disorders; Choreoballism; Hyperglycemia; Hypoglycemia; Putamen