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CC BY-NC-ND 4.0 · Asian J Neurosurg 2020; 15(01): 194-197
DOI: 10.4103/ajns.AJNS_218_19
Case Report

Coexisting moyamoya syndrome and type 1 diabetes mellitus: A case report and review of the literature

Nagarjun Bolem
Division of Neurosurgery, University Surgical Cluster, National University Hospital
,
Vincent Nga
Division of Neurosurgery, University Surgical Cluster, National University Hospital
,
Ning Chou
Division of Neurosurgery, University Surgical Cluster, National University Hospital
,
Tseng Yeo
Division of Neurosurgery, University Surgical Cluster, National University Hospital
,
Jeremy Lin
1   Department of Pediatric Medicine, Division of Pediatric Neurology, National University Hospital
,
Vijay Sharma
2   Division of Neurology, YLL School of Medicine, National University Hospital, National University of Singapore
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Moyamoya disease (MMD) is an incompletely understood malady that affects many age groups, primarily in a bimodal age distribution. We present a patient with the association of type 1 diabetes mellitus (type 1 DM) and MMD followed by a review of the existing literature. We found five papers that describe this association, in the form of one case report, one case series, and three retrospective reviews. Despite a poor understanding of the underlying pathophysiology, a clear association between autoimmune conditions and MMD appears to exist. Clinicians who manage such patients ought to be vigilant and have a high index of suspicion when young patients with type 1 DM present with new onset of neurological symptoms.

Key-words:

Chorea - external carotid–internal carotid bypass - hemiballismus - moyamoya disease - type 1 diabetes mellitus

Financial support and sponsorship

Nil.




Publication History

Received: 12 July 2019

Accepted: 11 September 2019

Article published online:
16 August 2022

© 2020. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Scott RM, Smith ER. Moyamoya disease and Moyamoya syndrome. N Engl J Med 2009;360:1226-37.
  • 2 Baba T, Houkin K, Kuroda S. Novel epidemiological features of Moyamoya disease. J Neurol Neurosurg Psychiatry 2008;79:900-4.
  • 3 Wakai K, Tamakoshi A, Ikezaki K, Fukui M, Kawamura T, Aoki R, et al. Epidemiological features of Moyamoya disease in Japan: Findings from a nationwide survey. Clin Neurol Neurosurg 1997;99 Suppl 2:S1-5.
  • 4 Han DH, Nam DH, Oh CW. Moyamoya disease in adults: Characteristics of clinical presentation and outcome after encephalo-duro-arterio-synangiosis. Clin Neurol Neurosurg 1997;99 Suppl 2:S151-5.
  • 5 Han DH, Kwon OK, Byun BJ, Choi BY, Choi CW, Choi JU, et al. Aco-operative study: Clinical characteristics of 334 Korean patients with Moyamoya disease treated at neurosurgical institutes (1976-1994). The Korean society for cerebrovascular disease. Acta Neurochir (Wien) 2000;142:1263-73.
  • 6 Mineharu Y, Liu W, Inoue K, Matsuura N, Inoue S, Takenaka K, et al. Autosomal dominant Moyamoya disease maps to chromosome 17q25.3. Neurology 2008;70:2357-63.
  • 7 Wang R, Xu Y, Lv R, Chen J. Systemic lupus erythematosus associated with Moyamoya syndrome: A case report and literature review. Lupus 2013;22:629-33.
  • 8 Kendall B. Cerebral angiography in vasculitis affecting the nervous system. Eur Neurol 1984;23:400-6.
  • 9 Sasaki T, Nogawa S, Amano T. Co-morbidity of Moyamoya disease with Graves' disease. Report of three cases and a review of the literature. Intern Med 2006;45:649-53.
  • 10 Carhuapoma JR, D'Olhaberriague L, Levine SR. Moyamoya syndrome associated with Sneddon's syndrome and antiphospholipid-protein antibodies. J Stroke Cerebrovasc Dis 1999;8:51-6.
  • 11 Fukui M, Kono S, Sueishi K, Ikezaki K. Moyamoya disease. Neuropathology 2000;20 Suppl:S61-4.
  • 12 Alexandrov AV, Sharma VK, Lao AY, Tsivgoulis G, Malkoff MD, Alexandrov AW, et al. Reversed Robin Hood syndrome in acute ischemic stroke patients. Stroke 2007;38:3045-8.
  • 13 Ahmad A, Paliwal P, Wakerley BR, Teoh HL, Sharma VK. Vascular contribution to hyperglycaemia-induced hemichorea. Diab Vasc Dis Res 2013;10:378-9.
  • 14 Akamatsu Y, Fujimura M, Sakata H, Endo H, Itabashi R, Tominaga T, et al. Acase of akin Moyamoya disease associated with type-I diabetes mellitus managed by extracranial-intracranial bypass. No Shinkei Geka 2015;43:227-33.
  • 15 Hughes JW, Wyckoff JA, Hollander AS, Derdeyn CP, McGill JB. Moyamoya syndrome causing stroke in young women with type 1 diabetes. J Diabetes Complications 2016;30:1640-2.
  • 16 Chen JB, Liu Y, Zhou LX, Sun H, He M, You C, et al. Prevalence of autoimmune disease in moyamoya disease patients in Western Chinese population. J Neurol Sci 2015;351:184-6.
  • 17 Bower RS, Mallory GW, Nwojo M, Kudva YC, Flemming KD, Meyer FB, et al. Moyamoya disease in a primarily white, Midwestern US population: Increased prevalence of autoimmune disease. Stroke 2013;44:1997-9.
  • 18 Wang CY, Grupke SL, Roberts J, Lee J, Fraser JF. Factors associated with Moyamoya syndrome in a Kentucky regional population. J Stroke Cerebrovasc Dis 2018;27:793-800.
  • 19 Ye L. The Epidemiology of Autoimmune Disease. Foreign Medical Sciences (Section of Dermatology and Venereology); 1982.
  • 20 Bower RS, Mallory GW, Nwojo M, Meyer FB, Kudva YC. Diabetes mellitus and the Moyamoya syndrome. Ann Intern Med 2012;157:387-8.
  • 21 Kushima K, Satoh Y, Ban Y, Taniyama M, Ito K, Sugita K, et al. Graves' thyrotoxicosis and Moyamoya disease. Can J Neurol Sci 1991;18:140-2.
  • 22 Bonduel M, Hepner M, Sciuccati G, Torres AF, Tenembaum S. Prothrombotic disorders in children with Moyamoya syndrome. Stroke 2001;32:1786-92.
  • 23 Provost TT, Moses H, Morris EL, Altman J, Harley JB, Alexander E, et al. Cerebral vasculopathy associated with collateralization resembling Moya Moya phenomenon and with anti-ro/SS-A and anti-la/SS-B antibodies. Arthritis Rheum 1991;34:1052-5.