An 18-year-old man with type 1 diabetes presented with acute bilateral arm and leg ballismus and oral-buccal dyskinesia. Glucose was 394 and HgbA1c >14. Imaging revealed T1 hyperintensity and susceptibility effect within the basal ganglia (Figure). Symptoms resolved over 48 hours with glucose control. A diagnosis of diabetic striatopathy was made. Diabetic striatopathy, also called hyperglycemic hemiballism/hemichorea, is most often described in older individuals with type 2 diabetes. Clinical symptoms often resolve with glycemic control; however, many patients require pharmacologic treatments. Deep brain stimulation may be beneficial in cases with disabling involuntary movements. Hyperglycemia-induced vasculopathy may contribute to microhemorrhages on imaging.^1,2

一名患有 1 型糖尿病的 18 岁男性出现急性双侧手臂和腿部弹道痉挛和口腔-颊部运动障碍。葡萄糖为 394，HgbA1c >14。成像显示基底节内的 T1 高信号和易感性效应（图）。通过血糖控制，症状在 48 小时内消退。诊断为糖尿病性纹状体病。糖尿病性纹状体病，也称为高血糖偏头痛/偏舞蹈症，最常见于患有 2 型糖尿病的老年人。临床症状通常随着血糖控制而消退；然而，许多患者需要药物治疗。在禁用不自主运动的情况下，深部脑刺激可能是有益的。高血糖引起的血管病变可能导致成像上的微出血。^1,2