Abstract
A 64-year-old diabetic female patient presented with involuntary unilateral hyperkinetic movements of the left limbs. Cranial MRI showed a contralateral high signal intensity putaminal lesion on T1-weighted images without any signal changes in the T2-weighted images. This finding is characteristic for hemichorea-hemiballism associated with insufficiently treated diabetes mellitus. Additionally, proton MR spectroscopy was performed and revealed a decreased N-acetylaspartate/creatine and N-acetylaspartate/choline ratio, indicating neuronal damage of the contralateral putamen.
© Georg Thieme Verlag KG Stuttgart · New York.
MeSH terms
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Aspartic Acid / analogs & derivatives
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Aspartic Acid / metabolism
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Choline / metabolism
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Chorea / diagnostic imaging*
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Chorea / physiopathology*
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Creatine / metabolism
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Diabetes Complications / diagnostic imaging*
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Diabetes Complications / physiopathology*
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Diabetes Mellitus, Type 2 / diagnostic imaging*
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Diabetes Mellitus, Type 2 / physiopathology*
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Diffusion Magnetic Resonance Imaging*
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Dominance, Cerebral / physiology*
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Female
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Glycated Hemoglobin / metabolism
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Humans
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Hyperglycinemia, Nonketotic / diagnostic imaging*
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Hyperglycinemia, Nonketotic / physiopathology*
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Magnetic Resonance Spectroscopy
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Middle Aged
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Putamen / diagnostic imaging*
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Putamen / physiopathology*
Substances
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Glycated Hemoglobin A
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hemoglobin A1c protein, human
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Aspartic Acid
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N-acetylaspartate
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Creatine
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Choline