Hyperglycemic choreoathetosis: Role of the putamen in pathogenesis
Identifieur interne : 002269 ( Main/Exploration ); précédent : 002268; suivant : 002270Hyperglycemic choreoathetosis: Role of the putamen in pathogenesis
Auteurs : Nagaendran Kandiah [Singapour] ; Kevin Tan [Singapour] ; C. C. Tchoyoson Lim [Singapour] ; Narayanaswamy Venketasubramanian [Singapour]Source :
- Movement Disorders [ 0885-3185 ] ; 2009-04-30.
Descripteurs français
- Pascal (Inist)
English descriptors
- KwdEn :
- Aged, Aged, 80 and over, Chorea (complications), Chorea (pathology), Choreoathetosis, Diffusion Magnetic Resonance Imaging (methods), Female, Humans, Hyperglycemia, Hyperglycemia (complications), Hyperglycemia (pathology), Magnetic Resonance Spectroscopy (methods), Male, Nervous system diseases, Pathogenesis, Putamen, Putamen (pathology), Retrospective Studies, Tomography, X-Ray Computed (methods), choreoathetosis, hyperglycemia, hyperviscosity, putamen, striatum.
- MESH :
- complications : Chorea, Hyperglycemia.
- methods : Diffusion Magnetic Resonance Imaging, Magnetic Resonance Spectroscopy, Tomography, X-Ray Computed.
- pathology : Chorea, Hyperglycemia, Putamen.
- Aged, Aged, 80 and over, Female, Humans, Male, Retrospective Studies.
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
Url:
DOI: 10.1002/mds.22277
Affiliations:
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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</div></front></TEI><affiliations><list><country><li>Singapour</li></country><orgName><li>Université nationale de Singapour</li></orgName></list><tree><country name="Singapour"><noRegion><name sortKey="Kandiah, Nagaendran" sort="Kandiah, Nagaendran" uniqKey="Kandiah N" first="Nagaendran" last="Kandiah">Nagaendran Kandiah</name></noRegion><name sortKey="Lim, C C Tchoyoson" sort="Lim, C C Tchoyoson" uniqKey="Lim C" first="C. C. Tchoyoson" last="Lim">C. C. Tchoyoson Lim</name><name sortKey="Lim, C C Tchoyoson" sort="Lim, C C Tchoyoson" uniqKey="Lim C" first="C. C. Tchoyoson" last="Lim">C. C. Tchoyoson Lim</name><name sortKey="Tan, Kevin" sort="Tan, Kevin" uniqKey="Tan K" first="Kevin" last="Tan">Kevin Tan</name><name sortKey="Venketasubramanian, Narayanaswamy" sort="Venketasubramanian, Narayanaswamy" uniqKey="Venketasubramanian N" first="Narayanaswamy" last="Venketasubramanian">Narayanaswamy Venketasubramanian</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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