非酮症高血糖偏侧舞蹈症5例临床特点分析

Clinical features of hemichorea associated with nonketotic hyperglycemia: An analysis of 5 cases

摘要:

由糖尿病引起的非酮症高血糖偏侧舞蹈症(HC-NH)临床较为罕见。该文报道了5例HC-NH患者，均为老年女性，平均年龄70岁，有糖尿病史，发病至入院时间4~30 d，糖化血红蛋白7.6%~17.5%。所有患者均自一侧肢体起病；1例患者头颅CT表现为发病对侧基底节区稍高密度影；3例患者MRI提示基底节区（单侧或双侧基底节）高信号，病灶呈团片状或斑点状；1例无MRI异常表现。所有患者在降糖或增加抗多巴胺能类药物治疗后症状缓解，预后良好。

Abstract:

Hemichorea associated with nonketotic hyperglycemia （HC-NH） caused by diabetes is relatively rare in clinical practice. This article reported 5 cases of HC-NH patients. All patients were elderly women， with an average age of 70 years and a history of diabetes. The time from disease onset to admission ranged from 4 to 30 days， and the level of glycosylated hemoglobin ranged from 7.6% to 17.5%. All patients had disease onset from one limb； 1 patient had slightly high-density shadow in the contralateral basal ganglia area on head CT scan； 3 patients’ showed high signal intensity in the basal ganglia (unilateral or bilateral) on MRI, and the lesions were mass flakes or spots； 1 patient had no abnormal manifestation on MRI. All patients achieved the relief of symptoms and had a good prognosis after hypoglycemic therapy or the addition of anti-dopaminergic drugs.