Case Of the Week (COW) 02 August 2015
HEMI CHOREA –HEMIBALLISMUS SYNDROME ( non ketotic hyperglycemia )
Findings
MRI –T 1 , Hyperintense lesion involving left lentiform nucleus , T 2 Isointense ,No e/o diffusion restriction , gradient blooming Biochemical Investigations -- fasting blood sugar- 405 mg /dl,HbA1C – 9.2 %, Urine ketones – negative
Discussion
Due to non ketotic hyperglycaemia. Usually in elderly patients, may be first ( unmasking ) symptom of type 2 DM. CT brain in these patients shows e/o striatal hyperdensity. MRI findings pathognomonic of HIHH are unilateral T 1 basal ganglia hyperintensity with sparing of thalamus. Cause of T1w hyperintensity – calcification, petechial haemorrhage.
Contributed By:
Prof. S Babu Peter, Dr. R Jayavarma, Prof K Malathy
Barnard Institute of Radiology
HEMI CHOREA –HEMIBALLISMUS SYNDROME ( non ketotic hyperglycemia )
Findings
MRI –T 1 , Hyperintense lesion involving left lentiform nucleus , T 2 Isointense ,No e/o diffusion restriction , gradient blooming Biochemical Investigations -- fasting blood sugar- 405 mg /dl,HbA1C – 9.2 %, Urine ketones – negative
Discussion
Due to non ketotic hyperglycaemia. Usually in elderly patients, may be first ( unmasking ) symptom of type 2 DM. CT brain in these patients shows e/o striatal hyperdensity. MRI findings pathognomonic of HIHH are unilateral T 1 basal ganglia hyperintensity with sparing of thalamus. Cause of T1w hyperintensity – calcification, petechial haemorrhage.
Contributed By:
Prof. S Babu Peter, Dr. R Jayavarma, Prof K Malathy
Barnard Institute of Radiology