非典型非酮症性高血糖合并偏侧舞蹈症1例病例报道

Atypical Hemichorea Associated with Non-Ketotic Hyperglycemia: A Case Report

摘要: 非酮症性高血糖合并偏侧舞蹈症(hemichorea associated with non-ketotic hyperglycemia, HC-NH)在临床上相对少见，1960年Bidwell首次报道，多见于长期血糖控制不良或新发糖尿病的老年患者，女性多见，平均年龄70岁。其典型表现为：非酮症性高血糖、偏侧舞蹈症及症状肢体对侧纹状体核磁T1高信号、CT高密度三联征。在临床上，对于新出现的舞蹈症，除应考虑脑卒中等常见原因外，如同时合并有糖尿病，还应考虑非酮症性高血糖合并偏侧性舞蹈病的可能。在临床上遇到相关患者应注重详细精确的病史询问、医学检验检查、体格检查，尽早诊断并针对病情给予积极专业的干预治疗，改善临床预后。本文通过回顾分析1例非酮症性高血糖伴偏侧性舞蹈病的临床特征、发病机理及影像学特征、治疗及预后，以加强临床医生对该病的认识，现将报道如下。

Abstract: Hemichorea associated with non-ketotic hyperglycemia (HC-NH) is relatively rare in clinical practice and was first reported by Bidwell in 1960. It is most common in elderly patients with long-term poor glycemic control or new-onset diabetes mellitus, and it is more common in females, with an average age of 70 years. Its typical manifestations are: non-ketotic hyperglycemia, lateralized cho-rea and the triad of nuclear magnetic T1 high signal in the striatum contralateral to the sympto-matic limb, and CT hyperdensity. In clinical practice, in addition to common causes such as stroke, the possibility of non-ketotic hyperglycemia combined with lateralized chorea should be considered in the case of new chorea, if it is combined with diabetes mellitus. In the clinical encounter with re-lated patients, we should pay attention to the detailed and precise history inquiry, medical test and physical examination, and try our best to diagnose and give active and professional interventions for the condition to improve the clinical prognosis. In this paper, the clinical features, pathogenesis and imaging characteristics, treatment and prognosis of one case of HC-NH were analyzed in retro-spect in order to enhance the clinicians’ understanding of this disease, and are reported as follows.