Category: Choreas (Non-Huntington's Disease)
Objective: To report diabetic patient with chronic renal failure who developed sudden chorea movements associated with reversible bilateral basal ganglia lesion.
Background: Acute movement disorder associated with reversible bilateral basal ganglia lesions is not rare syndrome in patients with diabetic uremia. Brain MRI in this syndrome revealed decreased signal intensity within the bilateral basal ganglia on T1 weighted images and increased signal intensity on T2 weighted images.
Method: Case report
Results: A patient 48-year-old man with histories of NIDDM and hypertension for more than 10 years. He had been diagnosed chronic renal insufficiency 3 years ago and started to receive regular hemodialysis 2-3 times per a week. Two days before admission he noted an acute onset of generalized chorea movement in his limbs and trunk in the morning. Neurologic exam revealed no cranial nerves signs, weakness and deep tendon reflex, and sensory abnormalities in the limbs. Constant chorea and ballistic movements were noted in the limbs and trunk and were not suppressed and sometimes interfered with voluntary movements such as standing and walking. Brain MRI showed hypo intensity in the bilateral basal ganglia on T1 – weighted images and hyper intensity on T2 – weighted images. After hemodialysis and supportive treatment in the hospital his generalized chorea was complete remission within 2 weeks. Follow up MRI 3 months after admission revealed complete remission of the lesion in the bilateral basal ganglia.
Conclusion: Acute chorea movement disorders associated with reversible bilateral basal ganglia lesions is not rare syndrome in patients with diabetic uremia. Thorough history of illness, neurologic exam, laboratory and specific findings on brain MRI are the most diagnostic tool of this syndrome with good prognosis.
To cite this abstract in AMA style:B. Tserensodnom. Reversible chorea due to bilateral basal ganglia lesion in diabetic uremic patient [abstract]. Mov Disord. 2022; 37 (suppl 2). https://www.mdsabstracts.org/abstract/reversible-chorea-due-to-bilateral-basal-ganglia-lesion-in-diabetic-uremic-patient/. Accessed March 2, 2024.
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MDS Abstracts - https://www.mdsabstracts.org/abstract/reversible-chorea-due-to-bilateral-basal-ganglia-lesion-in-diabetic-uremic-patient/