Objective: This study aims to analyze the clinical features, neuroimaging findings, and outcomes of diabetic striatopathy among Vietnamese patients.

Background: Diabetic striatopathy (DS) is a rare heterogeneous disease characterized by chorea/ballism and unique reversible lesions on brain imaging in hyperglycemic patients. Previous reports were in the form of case reports or small sample case series reports making them difficult to analyze.

Method: We reviewed retrospectively the DS cases follow up at our hospital. Collected data were choreic/ballistic patients who had diabetes mellitus (DM) and basal ganglia abnormalities on computed tomography (CT) and/or magnetic resonance imaging (MRI). Descriptive analysis was performed on demographic/clinical characteristics, locations of striatal abnormalities on neuroimages, treatment, and outcomes.

Results: In total, 36 patients were identified with median age 67 (interquantile range, IQR, 62-73). Older women are more frequently affected (86,7%). Among them, all the patients had type 2 DM with 6% being newly diagnosed. Median and IQR of blood glucose and glycated hemoglobin concentrations were 10.3mmol/L [6.45;15.8] and 11.4% [8.83;14.0], respectively. MRI was done in 32 (88,9%) patients while CT was done in 7 (19,4%) patients. The globus pallidus is the most common lesions (75% on MRI). We had two main types of hyperkinetic movement disorders (chorea/ballism=26 (72,2%)/ 10 (27,8%)). There were 29 (80.6%) patients who had hemichorea/hemiballism and 7 (19.4%) patients who had generalized chorea/ballism.  Locations of striatal abnormalities was pure putamen (19.4%, 7/36), pure globus pallidus (11.1%, 4/36), pure caudate nucleus (2,8%, 1/36), putamen and globus pallidus (41.7%, 15/36), putamen and caudate nucleus (8.3%, 3/36), and putamen, caudate nucleus and globus pallidus (16,7%, 6/36). In all the patients hyperglycemia were controlled and the most commonly used anti-chorea drug was risperidone (66.7%), and then haloperidol (33.3%). 47,2% of patients had their symptoms reduced, while 25% of patients recovered completely.

Conclusion: Our study has demonstrated the heterogeneity of DS in clinical, imaging and outcomes. Most DS patients had their symptoms reduced or recover with glucose control and antipsychotic medications.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/the-clinical-features-neuroimagings-and-outcomes-of-diabetic-striatopathy-a-retrospective-study-at-tertiary-hospital-in-vietnam/