糖尿病性偏侧舞蹈症临床特征研究（附二例患者临床报道）  

Hemichorea associated with diabetic hyperglycemia： a clinical characteristic analysis of 2 cases

作　　者：刘庆[1] 董庆林[1] 秦永春[2] 

机构地区：[1]山东省日照市人民医院神经内科,276826 [2]山东省日照市人民医院影像科,276826

出　　处：《中华神经医学杂志》2012年第1期87-90,共4页Chinese Journal of Neuromedicine

摘　　要：目的 探讨糖尿病性偏侧舞蹈症的临床特点和影像学表现. 方法 回顾性分析日照市人民医院神经内科2010年10月9日、29日收治的2例糖尿病性偏侧舞蹈症患者的临床症状、影像学特征等资料,并复习相关文献. 结果 2例均为老年女性糖尿病患者,舞蹈症状均为急性起病（1例在应用胰岛素控制血糖的过程中发生,l例在未用胰岛素控制血糖的情况下发生）,例2初为偏侧舞蹈症状,后出现双侧舞蹈症状.CT表现为舞蹈症状对侧的尾状核、壳核和苍白球的高密度影（CT值为50 Hu左右）.MRI表现为T1像尾状核、壳核和苍白球片状高信号,T2像低信号,局部有轻度萎缩现象,病变部位无强化现象.服用氟哌啶醇及氯硝安定对症状控制有效. 结论 糖尿病性偏侧舞蹈症多见于血糖控制不佳的糖尿病患者,可以双侧先后受累,在舞蹈症状的对侧基底节区有特征性的影像学改变.控制血糖是治疗的基础,氟哌啶醇和氯硝安定有助于舞蹈症状的控制.Objective To investigate the clinical characteristics and the imaging features of patients with hemichorea associated with hyperglycemia in primary diabetes mellitus （DM）. Methods We retrospectively analyzed the clinical manifestations and the neuroimaging features of 2 patients with hemichorea induced by hyperglycemia in primary DM, admitted to our hospital on 9 and 29 October 2010; the related literatures about this disease were reviewed. Results These 2 patiewnts were both old female diabetics with acute onset of symptomatic hemichorea. One had an outbreak during using insulin to control blood glucose and the other did without using insulin; at first,case 2 symptom of one side chorea was showed,and then both sides were noted.CT findings indicated T1-high-density shadow in the contralateral caudate nucleus, putamen and globus pallidus （CT values in 50 Hu or so）; MR imaging indicated that T1WI showed high-signal in the contralateral caudate nucleus,putamen and globus pallidus,while T2WI showed low-signal; partial light atrophy but no strengthening phenomenon in lesion location were noted. These patients were treated effectively with haloperidol and clonazepam.Conclusion Hemichorea induced by hyperglycemia often involves diabetic patients with poor glucose control. Characteristic imaging changes in the contralateral basal ganglia; blood glucose control is the foundation of treatment; haloperidol and clonazepam are helpful in controling hemichorea.

关 键 词：糖尿病 偏侧舞蹈症 临床症状 影像学特征 

分 类 号：R587.2[医药卫生—内分泌] R742.2[医药卫生—内科学]