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Bilateral dystonia in type 1 diabetes: a case report
Akihiro Yasuhara1, Jun Wada, Hirofumi Makino
1Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Okayama, Japan. akihiroyasuhara@yahoo.co.jp
Journal of Medical Case Reports
|November 20, 2008
Summary
Diabetic hemichorea-hemiballismus, a rare complication, can occur in type 1 diabetes. This case highlights hyperglycemia-induced involuntary movements like hemichorea and dystonia, which resolved with insulin and haloperidol.
Area of Science:
- Neurology
- Endocrinology
- Metabolic Disorders
Background:
- Diabetic hemichorea-hemiballismus is a rare complication typically associated with type 2 diabetes.
- This case presents a unique instance of hemichorea and bilateral dystonia in a patient with type 1 diabetes.
Purpose of the Study:
- To report a case of hyperglycemia-induced involuntary movement in a patient with type 1 diabetes.
- To illustrate the diagnostic features and successful management of this rare complication.
Main Methods:
- A 62-year-old woman presented with symptoms of uncontrolled diabetes and involuntary movements.
- Diagnostic workup included plasma glucose, HbA1c, glycated albumin, ketosis, GAD antibodies, C-peptide levels, and HLA typing.
- Treatment involved continuous intravenous insulin infusion and haloperidol.
Main Results:
- The patient exhibited extremely high glucose, HbA1c, and glycated albumin levels with ketosis.
- Diagnosis confirmed as type 1 diabetes mellitus based on autoantibodies and other markers.
- Involuntary movements (dystonia and hemichorea) completely resolved within 3 days of treatment.
Conclusions:
- Hyperglycemia-induced involuntary movement is a significant manifestation of dystonia and hemichorea-hemiballismus.
- Type 1 diabetes should be considered in the differential diagnosis of hyperglycemia-induced movement disorders.
- Prompt management of hyperglycemia and associated symptoms is crucial for recovery.
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