İlk semptom olarak koreoatetoik istemsiz hareketlerle prezente olan diabetes mellitus: Olgu sunumu
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Dosyalar
Tarih
2018
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info:eu-repo/semantics/openAccess
Özet
Koreoatetoz; kompleks, hiperkinetik, düzensiz, ani ve kısa süreli bir hareket bozukluğudur. Beraberinde bükülme şeklinde istemsiz hareketler de görülür. Herediter, immünolojik, metabolik, nörovasküler, enfeksiyona bağlı hastalıklar ve ilaç kullanımı bu duruma neden olabilmektedir. İleri yaşlarda özellikle vasküler hastalıklara bağlı olarak daha sık görülür. Metabolik nedenlere bağlı ise daha nadir görülür. Yetmiş üç yaşında erkek hasta, iki gündür sağ kolunu kontrol edememe şikayeti ile başvurdu. Özellikle yürürken belirginleşen sağ kolunda koreoatetoik hareketleri mevcuttu. Kan şekeri takip değerleri yüksekti. Amerikan Diyabet Birliği kriterlerine göre Tip 2 diabetes mellitus tanısı konuldu. Beyin manyetik rezonans görüntü-leme T1 sekansında solda daha belirgin olmak üzere kronik iskemik lezyonla uyumlu bilateral bazal ganglionlarda asimetrik hiperintensite saptandı. Subkutan insülin ile tedavi edildi. Koreoatetoik hareketleri 3. günden sonra azaldı ve 7. günde tamamen düzeldi. Bu durum putamen başta olmak üzere bazal ganglionlardaki etkilenmeler sonucu oluşur. Patofizyolojisinden GABA miktarıdaki azalma ve GABAerjik nöronların disfonksiyonu sorumlu tutulmaktadır. Bu nedenle akut gelişen koreoatetozda kan glukoz ve HbA1c değerlerinin saptanması önemlidir.
Choreoathetosis is complex, hyperkinetic, irregular, sudden and short-term movement disorder. Involuntary twisting movements are also seen toget-her. Hereditary, immunologic, metabolic, neurovascular, infection diseases and drugs can cause this disease. It is more common in elderly people due to vascular diseases. It is more rare due to metabolic causes. A 73-year-old male patient presented with the complaint of was not being able to control the right arm for two days. There was choreoathetoid movements in his right arm, especially when he was walking. His blood glucose levels were high. Type 2 diabetes mellitus was diagnosed according to American Diabetes Association criteria. In brain magnetic resonance imaging, asymmetric hyperintensity was detected in the basal ganglia consistent with chronic ischemic lesions, more prominent on the left in T1 sequence. He was treated with subcutaneous insulin. Choreoathetoid movements declined after the third day and recovered on the 7th day. This is a consequence of the effects of basal ganglia, especially putamen. The reduction in the amount of GABA and dysfunction of GABAergic neurons are responsible from pathophy-siology. Therefore, it is important to detect blood glucose and HbA1c levels in acute developing choreoathetosis.
Choreoathetosis is complex, hyperkinetic, irregular, sudden and short-term movement disorder. Involuntary twisting movements are also seen toget-her. Hereditary, immunologic, metabolic, neurovascular, infection diseases and drugs can cause this disease. It is more common in elderly people due to vascular diseases. It is more rare due to metabolic causes. A 73-year-old male patient presented with the complaint of was not being able to control the right arm for two days. There was choreoathetoid movements in his right arm, especially when he was walking. His blood glucose levels were high. Type 2 diabetes mellitus was diagnosed according to American Diabetes Association criteria. In brain magnetic resonance imaging, asymmetric hyperintensity was detected in the basal ganglia consistent with chronic ischemic lesions, more prominent on the left in T1 sequence. He was treated with subcutaneous insulin. Choreoathetoid movements declined after the third day and recovered on the 7th day. This is a consequence of the effects of basal ganglia, especially putamen. The reduction in the amount of GABA and dysfunction of GABAergic neurons are responsible from pathophy-siology. Therefore, it is important to detect blood glucose and HbA1c levels in acute developing choreoathetosis.
Açıklama
Anahtar Kelimeler
Genel ve Dahili Tıp, Koreoatetoz, Choreoathetosis, Hiperglisemi, Hyperglycemia
Kaynak
Fırat Tıp Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
23
Sayı
4
Künye
Eren, F., Aygül, R. (2018). İlk Semptom Olarak Koreoatetoik İstemsiz Hareketlerle Prezente Olan Diabetes Mellitus: Olgu Sunumu. Fırat Tıp Dergisi, 23(4), 196-199.
