# Two advanced-aged patients with diabetic striatopathy: a case report and literature review

## TL;DR

This paper reports two elderly patients with diabetic striatopathy, a rare diabetes complication, showing how symptoms improved with proper treatment.

## Contribution

The paper adds to the understanding of DS by presenting two elderly cases with ketotic hyperglycemia and atypical presentations.

## Key findings

- Both patients showed characteristic T1 hyperintensity in the basal ganglia on MRI.
- Symptoms resolved completely with intensive glycemic control and symptomatic therapy.
- DS can present in ketotic states, not just non-ketotic hyperglycemia.

## Abstract

Diabetic striatopathy (DS) is a rare neurological complication of diabetes mellitus, characterized by acute choreiform or ballistic movements and hyperintense basal ganglia lesions on T1-weighted MRI. While non-ketotic hyperglycemia is commonly implicated, DS can also occur in ketotic states.

We report two elderly patients with long-standing, poorly controlled diabetes. Case 1, an 80-year-old male, presented with bilateral lower limb choreiform movements and delirium. Case 2, a 92-year-old female, developed right-sided hemichorea after discontinuing hypoglycemic therapy. Both patients had hyperglycemia with ketosis and characteristic basal ganglia T1 hyperintensity. Intensive glycemic control and symptomatic therapy led to complete resolution of involuntary movements in both cases.

These cases highlight the heterogeneous clinical presentations of DS in advanced-aged patients and emphasize the importance of early recognition and prompt metabolic correction to achieve favorable neurological outcomes.