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Fortschr Neurol Psychiatr 2016; 84(04): 222-225
DOI: 10.1055/s-0042-104347
Kasuistik
© Georg Thieme Verlag KG Stuttgart · New York

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

Hemichorea with Contralateral High Signal Intensity Putaminal Lesion on T1-Weighted Images in Non-Ketotic Hyperglycemia
E. I. S. Achilles   *
1   Klinik und Poliklinik für Neurologie, Uniklinik Köln, Köln
,
V. Maus   *
2   Institut für Diagnostische und Interventionelle Radiologie, Uniklinik Köln, Köln
,
G. R. Fink
1   Klinik und Poliklinik für Neurologie, Uniklinik Köln, Köln
,
D. Maintz
2   Institut für Diagnostische und Interventionelle Radiologie, Uniklinik Köln, Köln
,
T. van Eimeren
1   Klinik und Poliklinik für Neurologie, Uniklinik Köln, Köln
,
A. Mpotsaris
2   Institut für Diagnostische und Interventionelle Radiologie, Uniklinik Köln, Köln
› Author Affiliations
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Publication History

Publication Date:
21 April 2016 (online)

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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

* Beide Autoren trugen gleichermaßen zu dieser Arbeit bei.


 

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