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Simultaneously occurring diabetic striatopathy and osmotic demyelination syndrome: A rare case report.

Title: Simultaneously occurring diabetic striatopathy and osmotic demyelination syndrome: A rare case report.
Authors: Christensen MJ; The University of Arizona College of Medicine Tucson, Tucson, AZ, USA.; Huff TJ; The University of Arizona College of Medicine Tucson, Tucson, AZ, USA.; Pickrell AM; The University of Arizona College of Medicine Tucson, Tucson, AZ, USA.; Rogers SN; The University of Arizona College of Medicine Tucson, Tucson, AZ, USA.
Source: The neuroradiology journal [Neuroradiol J] 2025 Dec; Vol. 38 (6), pp. 772-777. Date of Electronic Publication: 2025 Mar 17.
Publication Type: Journal Article; Case Reports
Language: English
Journal Info: Publisher: Sage Publications Country of Publication: United States NLM ID: 101295103 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2385-1996 (Electronic) Linking ISSN: 19714009 NLM ISO Abbreviation: Neuroradiol J Subsets: MEDLINE
Imprint Name(s): Publication: 2015- : Thousand Oaks, CA : Sage Publications; Original Publication: Bologna : Centauro
MeSH Terms: Demyelinating Diseases*/diagnostic imaging ; Demyelinating Diseases*/complications ; Diabetes Complications*/diagnostic imaging; Humans ; Male ; Middle Aged ; Magnetic Resonance Imaging ; Tomography, X-Ray Computed
Abstract: Diabetic striatopathy (DS), also known as non-ketotic hyperglycemic hemichorea, is a rare condition that arises from uncontrolled hyperglycemia. It is characterized by new onset movement disorders, changes in the striatum on imaging, or both. DS can occur as a complication of long-standing non-ketogenic hyperglycemia or be the first presentation of previously undiagnosed diabetes mellitus (DM). Additionally, uncontrolled or rapidly corrected hyperglycemia can, in rare cases, lead to osmotic demyelination syndrome (ODS). Although ODS typically occurs after the rapid correction of hyponatremia, the same effects and symptoms can manifest in patients with diabetes when hyperglycemia is corrected too quickly. We present a 59-year-old male with a history of uncontrolled diabetes mellitus and cerebrovascular accident who was brought to the emergency department by EMS with a new onset movement disorder. This case demonstrates a rare example of a patient presenting with classic imaging findings of both DS and ODS. Specifically, the patient demonstrated unilateral basal ganglia hyperdensity on CT, indicative of DS, alongside central pontine diffusion restriction and T2/FLAIR hyperintensity, consistent with ODS. This report discusses a rare case of the simultaneous occurrence of diabetic striatopathy and osmotic demyelination syndrome in a patient with uncontrolled diabetes mellitus, highlighting the intricate neurological complications of hyperglycemia. These findings stress the importance of timely recognition and management of hyperglycemia-related conditions, with imaging playing a pivotal role in diagnosis.
Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Contributed Indexing: Keywords: Diabetic striatopathy; MRI; diabetes mellitus; hemichorea; movement disorder; non-ketotic hyperglycemic hemichorea; osmotic demyelination syndrome
Entry Date(s): Date Created: 20250317 Date Completed: 20251119 Latest Revision: 20251119
Update Code: 20260130
PubMed Central ID: PMC11915231
DOI: 10.1177/19714009251324311
PMID: 40096849
Database: MEDLINE

Journal Article; Case Reports