- More common in hyperglycemic females
- Acute onset of involuntary movements involving one side of the body.
- Bilateral chorea is less common: in one retrospective study, only 6 of 53 patients experiencing abnormal movements had bilateral symptoms.
- Blood and urine ketones are not elevated, but there is high serum osmolality (hyperosmolar hyperglycemic state)
- Imaging findings are generally contralateral to the side of the body experiencing chorea.
- The putamen is most commonly involved, but other parts of basal ganglia can be affected as well.
- Noncontrast CT typically: unilateral hyperintensity of the basal ganglia.
Right hyperdense basal ganglia
– T1 hyperintensity, with more variable signal changes on T2 sequence.
– Restricted diffusion and hypointensity on susceptibility-weighted imaging also have been reported.
T1 hyperintense right basal ganglia
T2* sequence (GRE)
SWI sequence shows increased susceptibility in right basal ganglia.
- Signal abnormalities on MRI usually resolves several months to a year after chorea had subsided.
- Correction of hyperglycemia.
- Symtoms usually resolves within days to weeks of blood glucose normalization (a lag between symptom resolution and radiologic finding resolution)
- For patients with symptoms that persist despite glucose control, dopamine receptor blockers can be used.
More on basal ganglia abnormalities please visit this link: