Hemichorea mit T1-hyperintenser Signalalteration im kontralateralen Putamen bei nichtketotischer Hyperglykämie

Zusammenfassung

Eine 64-jährige Patientin mit Diabetes mellitus Typ 2 stellte sich mit einseitigen, unwillkürlichen hyperkinetischen Bewegungen der linken Extremitäten in unserer Klinik vor. In der cMRT zeigte sich eine T1-hyperintense Signalalteration im kontralateralen Putamen ohne Korrelat in den T2-Wichtungen, die charakteristisch für eine Hemichorea bzw. einen Hemiballismus bei entgleistem Diabetes mellitus ist. In der ergänzend durchgeführten MR-Spektroskopie zeigte sich ein erniedrigtes N-Acetylaspartat/Kreatin- und N-Acetylaspartat/Cholin-Verhältnis, was für einen neuronalen Zelluntergang im kontralateralen Putamen bei dieser Krankheitsentität spricht.

Abstract

A 64-year-old diabetic female patient presented with involuntary unilateral hyperkinetic movements of the left limbs. Cranial MRI showed a contralateral high signal intensity putaminal lesion on T1-weighted images without any signal changes in the T2-weighted images. This finding is characteristic for hemichorea-hemiballism associated with insufficiently treated diabetes mellitus. Additionally, proton MR spectroscopy was performed and revealed a decreased N-acetylaspartate/creatine and N-acetylaspartate/choline ratio, indicating neuronal damage of the contralateral putamen.

Schlüsselwörter

Hemichorea-Hemiballismus - Diabetes mellitus - Bewegungsstörungen

Key words

hemichorea-hemiballism - diabetes mellitus - movement disorders

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