非酮病性高血糖引起之單側舞蹈症病人獨特的臨床放射線表徵：2病例報告

Unique Clinicoradiological Manifestation in Patients with Hemiballism-Hemichorea Caused by Non-Ketotic Hyperglycemia: Report of Two Cases

我們報告2例老年男性因非酮病性高血糖引起之單側舞蹈症。病人之腦部電腦斷層掃瞄顯示對側豆狀核有高密度之病灶，磁振造影檢查則顯示在對側豆狀核有異常訊號之改變；T1影像為高的訊號及在T2影像則是低密度訊號。在高血糖獲得控制之後，病人們的過動現象立即戲劇性的消失，其中一位病人後續追蹤的腦部電腦斷層掃瞄及磁振造影檢查研究顯示，在3個月後腦部電腦斷層之高密度病灶完全的解決，而在6個月後磁振造影檢查之異常訊號亦消失。因此，我們認為此種獨特的臨床放射線表徵，可發生於因非酮病性高血糖引起之單側舞蹈症年老病人，經過適當處理之後預後非常良好。

In this report, we present 2 cases of hemiballism-hemichorea caused by non-ketotic hyperglycemia. Both were old patients, aged 62 and 69 respectiviely. Brain computed tomography (CT) revealed a hyperdense lesion in the putamen and magnetic resonance imaging (MRI) demonstrated an abnormal hyperintense focus in T1-weighted and hypointense focus in T2-weighted images at the corresponding areas for both cases. Their hyperkinesia disappeared with control of hyperglycemia. Follow-up in 1 patient demonstrated complete resolution of the lesion by CT 3 months later, that remained abnormal until 6 months later by MRI. The above findings suggest that hemiballism-hemichorea in old patients presented with non-ketotic hyperglycemia might show a charateristic clinicoradiological manifestation but of a good prognosis.