Related Experiment Videos
Chorea induced by non-ketotic hyperglycaemia: a case report
D Branca1, O Gervasio, E Le Piane
1Neurologic Unit, Azienda Ospedaliera Bianchi-Melacrino-Morelli, Via Melacrino, Reggio Calabria, Italy.
Summary
Sudden chorea in elderly patients may signal undiagnosed diabetes mellitus. Prompt insulin treatment normalized hyperglycemia and improved involuntary movements, suggesting a direct link.
Area of Science:
- Neurology
- Endocrinology
- Metabolic disorders
Background:
- Sudden onset chorea can present without apparent cause in elderly individuals.
- Undiagnosed diabetes mellitus, particularly non-ketotic hyperglycemia, is a potential, often overlooked, etiology.
- Standard neuroimaging may not reveal specific abnormalities in these cases.
Observation:
- An 81-year-old woman presented with acute, generalized chorea.
- She was found to have undiagnosed non-ketotic hyperglycemia.
- Brain MRI showed no basal ganglia abnormalities.
Findings:
- Subcutaneous insulin therapy led to normalized blood glucose levels.
- A parallel improvement in chorea symptoms was observed over nine days.
- This suggests non-ketotic hyperglycemia plays a direct role in chorea pathogenesis.
Implications:
- Diabetes mellitus should be considered in the differential diagnosis of new-onset chorea, irrespective of MRI findings.
- Early detection and management of hyperglycemia are crucial for resolving choreiform movements.
- This case highlights the importance of metabolic screening in neurological presentations.