Cranial Magnetic Resonance Imaging of Diabetic Chorea: Report of a Case and Review of the Literature

Abstract

A 81-year-old woman admitted for involuntary right-side movement of the body for eight days prior to admission. On admission, this movement was diagnosed neurologically as hemichorea. Voluntary plasma glucose was 422 mg/dl and HbA₁c 13.4%. Hemichorea disappeared a few days after insulin therapy was begun, and no relapse occurred. The definitive diagnosis was diabetic chorea. Brain magnetic resonance imaging (MRI) showed a high-intensity area in T1-weighted MRI and a low-intensity area in T2^*-weighted MRI in the left putamen. Interestingly, magnetic resonance angiography (MRA) showed an oozing-like intensity area with an irregular margin in the left putamen, which was not reported previously as a characteristic finding of diabetic chorea. This characteristic MRA finding disappeared four months later. We studied brain MRI findings of diabetic chorea based on our case and 9 others previously reported, concluding that these findings in the left putamen on T2^*-weighted MRI and MRA are useful for diagnosing diabetic chorea.