Please use this identifier to cite or link to this item: https://doi.org/10.1002/mds.22277
Title: Hyperglycemic choreoathetosis: Role of the putamen in pathogenesis
Authors: Kandiah, N.
Tan, K.
Lim, C.C.T. 
Venketasubramanian, N.
Keywords: Choreoathetosis
Hyperglycemia
Hyperviscosity
Striatum;putamen
Issue Date: 30-Apr-2009
Citation: Kandiah, N., Tan, K., Lim, C.C.T., Venketasubramanian, N. (2009-04-30). Hyperglycemic choreoathetosis: Role of the putamen in pathogenesis. Movement Disorders 24 (6) : 915-919. ScholarBank@NUS Repository. https://doi.org/10.1002/mds.22277
Abstract: Hyperglycemic choreoathetosis (HC) is an uncommon syndrome often associated with hyperintensity of the basal ganglia on MRI. We performed a retrospective review of cases with HC to characterize the clinical, biochemical, and neuroimaging (CT, MRI, and MR spectroscopy) findings and to propose a mechanism for this syndrome. Seven HC patients with a mean age of 75.1 years, mean blood glucose of 27.4 mmol/L, and mean plasma osmolarity of 313.4 mmol/L were studied. All had MR-T1 hyperintensity of the putamen on the side contralateral to the choreoathetosis. Two patients had additional hyperintensity of the globus pallidus while one also had involvement of the caudate. On MR-T2, 2 patients showed hyperintensity, 2 isointensity, and 3 hypointensity in the putamen. MR spectroscopy showed elevated choline and reduced N-acetylaspartate; two patients also had elevated myoinositol levels. Our findings suggest that the putamen has a central role in HC, and MR spectroscopy supports neuronal dysfunction in the putamen. Biochemical and neuroimaging findings support hyperviscosity as the most plausible mechanism. © 2009 Movement Disorder Society.
Source Title: Movement Disorders
URI: http://scholarbank.nus.edu.sg/handle/10635/108408
ISSN: 08853185
DOI: 10.1002/mds.22277
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