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• Vol.57 No.10
• CLINICA NEUROL, 57: 591−594, 2017
• Vol.57 No.10 contents

Brief Clinical Note

Effectiveness of levodopa treatment for diabetic chorea with reduced striatal accumulation in dopamine transporter SPECT: a case report

Katsunori Yokoi, M.D.¹⁾, Tomoyuki Kazuta, M.D.¹⁾, Ryouta Torii, M.D.¹⁾, Toshihiro Endo, M.D.¹⁾, Amane Araki, M.D.¹⁾ and Shinichi Terao, M.D.¹⁾

¹⁾Department of Neurology, Kasugai City Hospital

We report the case of a 77-year-old woman with diabetic chorea, which presented as hemiballism of the right limbs. Initial blood examination revealed that sugar and hemoglobin A1c levels were 732 mg/dl and 12.2%, respectively. Thus, a diagnosis of hyperglycemic hyperosmolar syndrome was made at a previous hospital. Ballism of the right limbs developed after 10 days and progressively worsened. After a month, the patient was admitted to our hospital. Brain MRI (axial T₁-weighted imaging) revealed a high-signal-intensity area in the left striatum. Dopamine transporter SPECT demonstrated reduced ¹²³I-ioflupane binding in the bilateral striatum with left side predominance. Although haloperidol and risperidone were ineffective for her involuntary movement, chlorpromazine had a little effect. Levodopa and gabapentin combination treatments were effective in decreasing the symptoms. It was considered that dopamine antagonist was the medical treatment for diabetic chorea and that levodopa could worsen neurological symptoms such as chorea-ballism. However, in our case, levodopa treatment was effective.
Full Text of this Article in Japanese PDF (444K)

(CLINICA NEUROL, 57: 591−594, 2017)
key words: diabetic chorea, ballism, levodopa, dopamine transporter SPECT

(Received: 29-Mar-17)