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Diabetic striatopathy in type 1 diabetes mellitus: a rare conundrum
  1. Vijayakumar Karthik1,
  2. Puthiyaveetil Khadar Jabbar2,
  3. Abilash Nair2 and
  4. Shameer Basheer2
  1. 1Endocrinology, Government Medical College Thiruvananthapuram, Thiruvananthapuram, Kerala, India
  2. 2Government Medical College Thiruvananthapuram, Thiruvananthapuram, Kerala, India
  1. Correspondence to Dr Vijayakumar Karthik; kannanhbk91{at}gmail.com

Abstract

Diabetic striatopathy is a clinicoradiological syndrome characterised by acute hyperkinetic movement disorder in the form of hemichorea-hemiballism with basal ganglia abnormalities in neuroimaging. The hallmark basal ganglia abnormalities appear as hyperdensities in CT brain and hyperintensities in MRI brain, which could mislead the clinician towards an erroneous diagnosis of cerebral haemorrhage. It is classically described in elderly patients with type 2 diabetes mellitus, and its occurrence in type 1 diabetes is extremely rare. This case report entails the clinical details of a young man in his 20s with type 1 diabetes mellitus who had uncontrolled blood glucose levels and presented with a recent onset of abnormal movements in his left upper and lower limbs. The semiology, biochemistry and radiological investigation findings and treatment are detailed. A clear understanding of the condition could lead to an early diagnosis, spare the patient unnecessary investigations and improve treatment outcomes.

  • Diabetes
  • Movement disorders (other than Parkinsons)

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Footnotes

  • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content: VK, PKJ, AN, SB. The following authors gave final approval of the manuscript: VK, PKJ, AN, SB.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.