To explore the clinical and imaging features of diabetic striatopathy(DS).

The clinical and imaging data of a patient with recurrent DS who was admitted to Department of Neurology of Suzhou Kowloon Hospital, Shanghai Jiao Tong University School of Medicine on November 12, 2020, were analyzed retrospectively, and the literature was reviewed to summarize the disease's clinical and imaging features.

An eldly female patient was admitted for a 2 d dance-like movement on the left side of her upper limb. At the time of admission, the random venous glucose level was 38.62 mmol/L. Cranial CT revealed a high density shadow in the right basal ganglia, while cranial MRI revealed a high signal intensity in the right striatum on T₁WI, with no obvious abnormal signal on susceptibility weighted imaging (SWI). Insulin hypoglycemic therapy, fluid rehydration, electrolyte correction, and other symptomatic treatments such as anti-platelet aggregation, lipid-stabilizing plaque, improving circulation, nourishing brain cells, and regulating blood pressure were administered to the patient. A week later, blood glucose control had stabilized, and a cranial MRI revealed that the high signal intensity of the right striatum T₁WI had been reduced, and the symptoms had been improved. One month after discharge, the patient was readmitted to the hospital due to involuntary writhing of the left lower limb. A re-examination of the cranial MRI revealed a high T₁WI signal in the right striatum, a slight increase in blood glucose with high inflammatory markers, and infection of both lungs. After receiving hypoglycemic and anti-infection treatment, the patient′s lower limb symptoms resolved.

Patients with subacute unilateral dance-like dyskinesia, poorly controlled diabetes, contralateral striatum high density shadow, and T₁WI high signal on cranial CT and MRI should be evaluated for DS. Infection can also cause disease recurrence, and the imaging manifestations of the disease are reversible to some extent.