# Irreversible Diabetic Striatopathy in Reversible Diabetes

## TL;DR

A rare neurological condition called diabetic striatopathy occurred in a woman with steroid-induced diabetes and resolved partially after treatment.

## Contribution

This case highlights DS as a potential complication of steroid-induced diabetes and its possible reversal with treatment.

## Key findings

- Diabetic striatopathy occurred in a patient with steroid-induced diabetes and resolved after glucocorticoid withdrawal.
- Neurological symptoms improved with glycemic control and medication, but some deficits remained.
- MRI showed gliotic changes in the striatum following the condition.

## Abstract

Diabetic striatopathy (DS) is a rare neurometabolic complication of poorly controlled diabetes, typically presenting as hemichorea-hemiballismus. It is most often associated with long-standing diabetes but can rarely occur in steroid-induced diabetes. We report the case of a 59-year-old woman with chronic kidney disease and hypertension who developed new-onset diabetes mellitus and right-sided hemichorea following corticosteroid therapy for nonproliferative glomerulopathy. Magnetic resonance imaging (MRI) confirmed DS with hyperintensity in the left lentiform nucleus. Despite initially requiring insulin, her diabetes resolved entirely following glucocorticoid withdrawal. Choreiform movements improved significantly with glycemic control and neuroleptics; however, residual hemichorea persisted. Follow-up MRI revealed gliotic changes in the striatum. This case highlights the importance of recognizing DS as a possible complication of steroid-induced diabetes. Timely identification and glycemic control can reverse both metabolic and neurological complications, although residual deficits may persist.