Nonketotic Hyperglycemic Hemiballism Treated with Stereotactic pallidotomy

以立體定位蒼白球燒灼術治療因非酮類高血糖引起之半邊舞蹈症

周德陽(Der-Yang Cho) ； 李文源(Wen-Yuan Lee)

《Mid-Taiwan Journal of Medicine》 8卷1期 (2003/03) Pp. 53-58

https://doi.org/10.6558/MTJM.2003.8(1).10

摘要

半邊舞蹈症是不尋常之不自主運動。因糖尿病病人導致之半邊舞蹈症是很罕見，目前文獻上只有廿三例報告。我們報告兩例因非酮類高血糖引起之舞蹈症，他們分別經過四個月及六個月藥物治療，雖然其血糖已獲得控制但仍無效，才考慮用手術治療。所以他們經過立體定位手術之蒼白球燒灼手術來治療半邊舞蹈症，在磁振造影上其病灶有特殊表徵，就是在T1影像上之對側蒼白球位置呈現高信號，此種信號有利於立體定位燒灼。我們所報告之二例，是目前文獻上僅有二例用立體定位蒼白球燒灼來治療半邊舞蹈症之病例。他們皆獲得良好之預後且恢復正常生活。

關鍵字

立體定位蒼白球燒灼術 ； 半邊舞蹈症 ； 非酮類高血糖症

並列摘要

Hemiballism is an unusual involuntary movement. Diabetes mellitus (DM) induced hemiballism is rare and only 23 patients with the disorder have been reported in the literature. We report two patients with nonketotic hyperglycemic hemiballism. They were refractory to medicine for four and six months respectively even though their serum glucose levels were well controlled. Therefore, they underwent stereotactic pallidotomy for the treatment of these hemibalIisms. Magnetic resonance imaging (MRI) revealed a characteristic hyperintensity lesion on Tl-weighted images on the contralateral side of the basal ganglia. These are the first two published cases of hemiballism treated with stereotactic pallidotomy. Both patients had satisfactory outcomes and returned to normal daily life.

並列關鍵字

hemiballism ； non-ketotic hyperglycemic ； stereotactic pallidotomy