Supplementary Material for: Persistent Hemichorea and Caudate Atrophy in Untreated Diabetic Striatopathy: A Case Report

<b><i>Background:</i></b> Neurological complications of diabetes and hyperglycemia are relatively common but the specific manifestations can vary widely. Diabetic striatal disease or “diabetic striatopathy” is an uncommon condition usually thought to result from hyperglycemic injury to the basal ganglia, producing a hyperkinetic movement disorder, usually choreiform in nature. Symptoms are generally reversible with treatment of the hyperglycemia. <b><i>Case Description:</i></b> We report the case of a 57-year-old woman presenting with a unilateral choreoathetosis of the left upper extremity, persistent for 4 years. Contemporaneous imaging demonstrated severe atrophy of the right caudate nucleus, while imaging obtained at the onset of symptoms was consistent with a right diabetic striatopathy. Symptoms improved with the use of dopamine antagonists and benzodiazepines. <b><i>Conclusion:</i></b> Although generally considered to be fully reversible, this case demonstrates that diabetic striatopathy can result in permanent structural lesions with persistent symptoms if left untreated.

**背景：** 糖尿病与高血糖症的神经系统并发症相对常见，但具体临床表现差异极大。糖尿病性纹状体病（diabetic striatopathy）是一种少见病症，通常被认为由高血糖损伤基底神经节所致，可引发运动亢进性运动障碍，多呈舞蹈样表现。经高血糖症治疗后，症状通常可逆转。**病例描述：** 本研究报告1例57岁女性患者，表现为左侧上肢单侧舞蹈手足徐动症，症状持续4年之久。同期影像学检查显示患者右侧尾状核存在严重萎缩，而症状发作时的影像学检查结果符合右侧糖尿病性纹状体病变表现。使用多巴胺拮抗剂与苯二氮䓬类药物治疗后，患者症状有所改善。**结论：** 尽管糖尿病性纹状体病变通常被认为可完全逆转，但本病例表明，若未及时治疗，该病可引发永久性结构性损伤，并导致症状持续存在。