Diabetic striatopathy in an adult with ketotic hyperglycaemia

Abstract

Diabetic striatopathy (DS) is a rare and life-threatening mani- festation of diabetes. The disease commonly affects individuals of Asian descent, women and the elderly. DS is characterized by dyskinesias with basal ganglia hyperintensities on imaging. Despite being rare, prompt recognition of a hyperglycaemia- induced hemichorea–hemiballismus is essential because the symptoms are reversible with correction of hyperglycaemia. Diagnosis is based on blood analysis and neuroimaging findings. Laboratory tests reveal raised glycosylated haemoglobin (HbA1c) levels, which indicate poorly controlled diabetes. Neuroimaging provides suggestive findings of DS. It is usually associated with non-ketotic hyperglycaemia. We report a 50-year-old woman who presented with ketotic hyperglycaemia and left-sided hemichorea and partial seizures with secondary generalization.