# Unraveling Diabetic Striatopathy: Clinical and Imaging Perspectives

## TL;DR

This paper presents a case of diabetic striatopathy, a movement disorder linked to high blood sugar, and highlights the importance of proper diagnosis and treatment.

## Contribution

The paper contributes a detailed case report of diabetic striatopathy and emphasizes its clinical and diagnostic features.

## Key findings

- A 67-year-old female with poorly controlled diabetes showed symptoms of hemichorea and hyperglycemia.
- Neuroimaging revealed a hyperdensity in the right lentiform nucleus, consistent with diabetic striatopathy.
- Treatment with VMAT inhibitors and glycemic control led to significant symptom improvement within 10 days.

## Abstract

Diabetic striatopathy (DS) is an acute hyperkinetic movement disorder arising from non-ketotic hyperglycemia. This condition predominantly affects females and is more common in the elderly, highlighting the interplay between diabetes, striatal pathology, and neurological movement disorders. DS is characterized by involuntary movements, such as hemichorea or hemiballism, and distinctive neuroimaging findings that can be mistaken for more common cerebrovascular events.

In this case report, we describe a 67-year-old female with a history of poorly controlled type 2 diabetes mellitus who presented with the sudden onset of involuntary movements affecting her left upper and lower limbs. Clinical examination and laboratory investigations revealed hyperglycemia without ketosis. Neuroimaging via computed tomography (CT) of the brain identified a hyper density in the right lentiform nucleus, consistent with DS. The patient was treated with vesicular monoamine transporter 2 (VMAT) inhibitors, oral hypoglycemic agents, and insulin, resulting in marked symptom improvement over 10 days. This case underscores the importance of recognizing DS as a differential diagnosis in patients with hyperkinetic movement disorders and hyperglycemia. Proper diagnosis and management, including stringent glycemic control, are crucial for symptom resolution.