MR Neuroimaging Findings in Adult Diabetic Patients- Two Case Reports

Diabetes Mellitus (DM) can affect any part of the central and peripheral nervous systems. Significant variations in glucose levels are often symptomatic. Hypoglycaemia as well as hyperglycaemia can present a wide variety of clinical symptoms. Imaging helps by suggesting the correct diagnosis and ens...

Full description

Bibliographic Details
Main Authors: Vishal Rajkumar Gudlani, Prashant Titare, M Pooja, Varsha Rote-Kaginalkar
Format: Article
Language:English
Published: JCDR Research and Publications Private Limited 2023-05-01
Series:Journal of Clinical and Diagnostic Research
Subjects:
Online Access:https://jcdr.net/articles/PDF/17940/60870_CE[Ra1]_F(IS)_PF1(Vi_HJ_SS)_PN(KM).pdf
_version_ 1797813461818802176
author Vishal Rajkumar Gudlani
Prashant Titare
M Pooja
Varsha Rote-Kaginalkar
author_facet Vishal Rajkumar Gudlani
Prashant Titare
M Pooja
Varsha Rote-Kaginalkar
author_sort Vishal Rajkumar Gudlani
collection DOAJ
description Diabetes Mellitus (DM) can affect any part of the central and peripheral nervous systems. Significant variations in glucose levels are often symptomatic. Hypoglycaemia as well as hyperglycaemia can present a wide variety of clinical symptoms. Imaging helps by suggesting the correct diagnosis and ensuring early treatment. We hereby present two cases, one of hypoglycaemic encephalopathy and a case of diabetic striatopathy. A 40-year-old female with a 25-year-old history of type 2 diabetes was brought into the emergency room in an unresponsive state since afternoon. The blood glucose was 28 mg/dL, and immediate administration of D 25%x2 stat was done. MRI revealed hyperintensities in the bilateral hippocampi and in the cortex of the bilateral high parietal region on T2WI/FLAIR. Despite intensive medical treatment the patient’s neurologic condition didn’t improve, due to irreversible brain tissue damage, and the patient ultimately died. A 63-year-old male was brought by relatives to causality with complaints of involuntary movements of the right-side of the body since three months, but symptoms have exaggerated since three days. Newly diagnosed DM since three months was on medication T.Metformin 500 mg BD. MRI revealed T1 hyperintensities in posterior half of left putamen. Patient was put on Inj. haloperidol 0.5 mg SOS, T.Aspirin 150 mg OD, T.Atorva 20 mg HS, T.sodium valproate 200 mg BD, T.tetrabenazine 25 mg BD and T.Serenace 0.5 mg BD and patient had improved symptomatically after 15 days of treatment. Imaging can play a crucial role in diagnosis and guide treatment and markedly influence the prognosis of patient.
first_indexed 2024-03-13T07:52:15Z
format Article
id doaj.art-9f61a2a50f394954ad205dafc0ba6619
institution Directory Open Access Journal
issn 2249-782X
0973-709X
language English
last_indexed 2024-03-13T07:52:15Z
publishDate 2023-05-01
publisher JCDR Research and Publications Private Limited
record_format Article
series Journal of Clinical and Diagnostic Research
spelling doaj.art-9f61a2a50f394954ad205dafc0ba66192023-06-02T10:58:19ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2023-05-01175TD07TD1010.7860/JCDR/2023/60870.17940MR Neuroimaging Findings in Adult Diabetic Patients- Two Case ReportsVishal Rajkumar Gudlani0Prashant Titare1M Pooja2Varsha Rote-Kaginalkar3Postgraduate Student, Department of Radiodiagnosis, Government Medical College, Aurangabad, Solapur, Maharashtra, India.Associate Professor, Department of Radiodiagnosis, Government Medical College, Aurangabad, Solapur, Maharashtra, India.Senior Resident, Department of Radiodiagnosis, Government Medical College, Aurangabad, Solapur, Maharashtra, India.Professor and Head, Department of Radiodiagnosis, Government Medical College, Aurangabad, Solapur, Maharashtra, India.Diabetes Mellitus (DM) can affect any part of the central and peripheral nervous systems. Significant variations in glucose levels are often symptomatic. Hypoglycaemia as well as hyperglycaemia can present a wide variety of clinical symptoms. Imaging helps by suggesting the correct diagnosis and ensuring early treatment. We hereby present two cases, one of hypoglycaemic encephalopathy and a case of diabetic striatopathy. A 40-year-old female with a 25-year-old history of type 2 diabetes was brought into the emergency room in an unresponsive state since afternoon. The blood glucose was 28 mg/dL, and immediate administration of D 25%x2 stat was done. MRI revealed hyperintensities in the bilateral hippocampi and in the cortex of the bilateral high parietal region on T2WI/FLAIR. Despite intensive medical treatment the patient’s neurologic condition didn’t improve, due to irreversible brain tissue damage, and the patient ultimately died. A 63-year-old male was brought by relatives to causality with complaints of involuntary movements of the right-side of the body since three months, but symptoms have exaggerated since three days. Newly diagnosed DM since three months was on medication T.Metformin 500 mg BD. MRI revealed T1 hyperintensities in posterior half of left putamen. Patient was put on Inj. haloperidol 0.5 mg SOS, T.Aspirin 150 mg OD, T.Atorva 20 mg HS, T.sodium valproate 200 mg BD, T.tetrabenazine 25 mg BD and T.Serenace 0.5 mg BD and patient had improved symptomatically after 15 days of treatment. Imaging can play a crucial role in diagnosis and guide treatment and markedly influence the prognosis of patient.https://jcdr.net/articles/PDF/17940/60870_CE[Ra1]_F(IS)_PF1(Vi_HJ_SS)_PN(KM).pdfdiabetes mellitusdiffusion-weighted imaginghemichorea-hemiballismushypoglycaemic encephalopathyhyperglycaemiamagnetic resonance imaging
spellingShingle Vishal Rajkumar Gudlani
Prashant Titare
M Pooja
Varsha Rote-Kaginalkar
MR Neuroimaging Findings in Adult Diabetic Patients- Two Case Reports
Journal of Clinical and Diagnostic Research
diabetes mellitus
diffusion-weighted imaging
hemichorea-hemiballismus
hypoglycaemic encephalopathy
hyperglycaemia
magnetic resonance imaging
title MR Neuroimaging Findings in Adult Diabetic Patients- Two Case Reports
title_full MR Neuroimaging Findings in Adult Diabetic Patients- Two Case Reports
title_fullStr MR Neuroimaging Findings in Adult Diabetic Patients- Two Case Reports
title_full_unstemmed MR Neuroimaging Findings in Adult Diabetic Patients- Two Case Reports
title_short MR Neuroimaging Findings in Adult Diabetic Patients- Two Case Reports
title_sort mr neuroimaging findings in adult diabetic patients two case reports
topic diabetes mellitus
diffusion-weighted imaging
hemichorea-hemiballismus
hypoglycaemic encephalopathy
hyperglycaemia
magnetic resonance imaging
url https://jcdr.net/articles/PDF/17940/60870_CE[Ra1]_F(IS)_PF1(Vi_HJ_SS)_PN(KM).pdf
work_keys_str_mv AT vishalrajkumargudlani mrneuroimagingfindingsinadultdiabeticpatientstwocasereports
AT prashanttitare mrneuroimagingfindingsinadultdiabeticpatientstwocasereports
AT mpooja mrneuroimagingfindingsinadultdiabeticpatientstwocasereports
AT varsharotekaginalkar mrneuroimagingfindingsinadultdiabeticpatientstwocasereports