Acute bilateral basal ganglia lesions in diabetic uraemia: Diffusion-weighted MRI

Eun Ja Lee, Jong Ho Park, Yon Kwon Ihn, Young Joo Kim, Seon Kyu Lee, Chan Sup Park

Research output: Contribution to journalArticle

39 Scopus citations

Abstract

Methods: We studied four patients with diabetes mellitus and chronic renal failure who developed sudden choreic movement disorders. The clinical manifestations, laboratory findings, MR imaging findings, and clinical outcome in each patient were evaluated. Results: All four patients had long-term diabetes mellitus and severe azotaemia. Brain MR findings consisted of bilateral symmetric basal ganglia lesions, with decreased signal intensity on T1-weighted images and increased signal intensity on T2-weighted images. All three patients who underwent diffusion-weighted MR imaging (DWI) showed signal intensities similar to those of the surroundings in regions corresponding to increased signal intensity on T2-weighted images, with slightly increased apparent diffusion coefficient (ADC) values. Two of the patients showed small focal areas of restricted diffusion within the basal ganglia lesions. After haemodialysis, follow-up MR imaging in all patients demonstrated that the basal ganglia lesions had regressed markedly, with some residual changes. The movement disorders also improved in all patients. Conclusion: A syndrome associated with acute bilateral basal ganglia lesions in diabetic uraemic patients is rare, with reversible changes demonstrated by clinical and imaging findings. DWI showed that the bilateral basal ganglia lesions in this syndrome were primarily vasogenic in origin, although there were small foci of cytotoxic oedema within the lesions.

Original languageEnglish (US)
Pages (from-to)1009-1013
Number of pages5
JournalNeuroradiology
Volume49
Issue number12
DOIs
StatePublished - Dec 1 2007
Externally publishedYes

Keywords

  • Basal ganglia
  • Diabetic mellitus
  • Diffusion-weighted imaging
  • Magnetic resonance imaging
  • Uraemia

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine

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