Abstract
An 88-year-old woman, with a diabetic history of at least 6 years, was admitted to another hospital at 85 years of age, with involuntary movement and hyperglycemia. She was subsequently treated with insulin injections once per day. In consideration of her advanced age, an attempt was made to decrease the dose of insulin by administering a DPP-4 inhibitor. However, the patient's HbA1c level had been elevated (8.9-15.0 %) for two months and choreiform movement began to affect her left upper limb. She was therefore admitted to our hospital to undergo further examinations and treatment. The chorea rapidly disappeared after the correction of dehydration and hyperglycemia by fluid replacement and insulin therapy, respectively. Her involuntary movement was definitely diagnosed as diabetic chorea (DC) based on her clinical course and the cranial diagnostic imaging findings. To prevent other involuntary actions, 123I-Ioflupane SPECT was performed, which showed a decreased level of dopamine transporters in the corpus striatum on the affected (right) side. We found no reports evaluating the mechanisms of DC based on neurophysiological findings. The findings in the present case could therefore be considered to be important in further investigations to elucidate the etiology of DC.
