Chorea due to diabetic hyperglycemia and uremia: distinct clinical and imaging features

Mov Disord. 2015 Mar;30(3):419-22. doi: 10.1002/mds.26148. Epub 2015 Feb 4.

Abstract

This study was undertaken to describe the clinical and imaging characteristics of patients with chorea associated with nonketotic hyperglycemia (C-NKH) in comparison with patients with chorea associated with uremia (C-URE). We retrospectively analyzed the clinical data of consecutive 10 C-NKH and five C-URE patients who were treated between January 1, 2001 and January 31, 2013. Women were more frequently affected by C-NKH (70% vs. 30%) and C-URE (80% vs. 20%) compared with men. The C-NKH patients demonstrated T1-hyperintense and inhomogeneous lesions in the basal ganglia, whereas C-URE patients demonstrated T2-hyperintense and homogeneous lesions in the basal ganglia. The mean time for chorea resolution after treatment was significantly shorter in C-NKH patients than in C-URE patients (4.4 ± 2.6 d vs. 73.8 ± 14.2 d, respectively; P = 0.005). The clinical and imaging features are remarkably different between C-NKH and C-URE patients, suggesting distinct pathogenic mechanisms.

Keywords: Chorea; diabetes; hyperglycemia; magnetic resonance imaging; uremia.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Brain / pathology
  • Chorea / diagnosis
  • Chorea / etiology*
  • Diabetes Complications / physiopathology*
  • Female
  • Follow-Up Studies
  • Humans
  • Hyperglycemia / complications*
  • Hyperglycemia / etiology*
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Retrospective Studies
  • Uremia / complications*