Diabetic striatopathy is a rare neurological complication in diabetics.
Mechanism: vascular perfusion resulting in metabolic derangement
The striatum is part of the basal ganglia and composed of the caudate, putamen and ventral striatum.
A key finding is hyperintensity in T1-weighted signals of the striatum with hypo/iso intensity on T2-weighted images.
The MRI findings are usually unilateral but can be bilateral.
Clinical findings:
(1) diabetes mellitus, usually type 2
(2) history of poor glycemic control with hyperglycemia with or without ketoacidosis
(3) involuntary movement disorder contralateral to the involved basal ganglia (may be bilateral if there is bilateral involvement of the basal ganglia)
(3a) hemichorea-hemiballism if unilateral
(3b) bilateral chorea
(4) variable disturbed consciousness
If diagnosed early with good glycemic control then the prognosis is usually good. A delay in diagnosis or poor glucose management can result in morbidity and mortality.
