摘要
目的探讨非酮症高血糖性偏侧舞蹈症的临床表现、发病机制、影像学表现及治疗。方法回顾性分析了淮南东方医院神经内科近2年收治的3例非酮症高血糖性偏侧舞蹈症患者,对其临床表现、影像学特点及发病机制等方面进行分析讨论。结果 3例均为老年女性糖尿病患者,血糖控制不理想,舞蹈症状均为急性起病,以一侧为主,头部影像学检查CT显示患肢对侧尾状核头和壳核呈高密度,MRI显示T1加权像呈高信号,T2加权像呈稍低或等信号,DWI像呈稍高或等信号。经降糖、补液治疗,并服用氟哌啶醇症状控制较好。结论非酮症高血糖性偏侧舞蹈症多见于长期糖尿病血糖控制不佳的高血糖症患者,病变部位以纹状体为主,影像学表现特殊,控制血糖,服用氟哌啶醇和氯硝安定有助于舞蹈症状的控制。
Objective To investigate the clinical manifestation, pathogenesis, imaging features and treatment methods of non - ke- totic hyperglycemia chorea, and to give advice on avoiding misdiagnosis. Methods Retrospective analysis was conducted in 3 patients admit- ted to our hospital these 2 years suffered with non - ketotic hyperglycemia chorea. And clinical manifestation, radiographic features and path- ogenesis of those patients were analyzed. Results All of the 3 cases were old female patients with unsatisfactorily controlled diabetic, acute onset one - sided chorea and typical imaging performance. CT showed high density in the lateral head of the caudate nucleus and putamen, T1 - weighted MR images showed high signal, T2 - weighted MR images showed slightly low or equal signal, and DWI findings showed slightly higher or equal signal. And symptoms of all the 3 patients were well controlled after treatment of glucose - lowering, rehydration and taking haloperidol and clonazepam. Conclusion Non - ketotic hyperglycemia chorea occurred mostly in patients with uncontrolled blood glu- cose level for a long term, lesion region in corpus striatum, and particular imaging performance, glucose - lowering. Treatments of rehydra- tion and taking haloperidol and clonazepam could benefit control of chorea.
出处
《安徽医学》
2013年第7期931-933,共3页
Anhui Medical Journal
