Diabetic striatopathy in the elderly: Clinical and radiological manifestations

Abstract Diabetic striatopathy (DS) can be a reversible emergency with a good prognosis when diagnosed and treated timely. However, patients with diabetic striatopathy are easily misdiagnosed mainly due to its rarity and most physicians’ unfamiliarity. Therefore, we conducted this study to reveal the clinical-radiographic features of diabetic striatopathy and advance our knowledge of this rare but important condition. We retrospectively reviewed and analyzed the clinical data of patients with diabetic striatopathy in our hospital between January 2013 and July 2022. Four cases were finally included, and the mean age of the identified patients was (63 ± 9) years. We found that the majority (75%) of patients were newly diagnosed as having type 2 diabetes mellitus and the average levels of blood glucose and hemoglobin A1C were 275 mg/dL and 13.0%, respectively. One patient was positive for ketone bodies. All the patients were presented with continuous and involuntary motion of their extremities. The most commonly involved body regions were lateral arm-leg. The commonly involved concomitant regions on CT and MRI were putamen and globus pallidus. Three of the four cases achieved substantial recovery with glucose-control treatments and anti-chorea medications within 10 days. Our finding suggests that it is of great importance to be aware of diabetic striatopathy when across with patients suffering from acute onset of hemi-chorea even though they have not a prior history of diabetes.