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Hemichorea-hemiballismus in non-ketotic hyperglycaemia
1Department of Radiology, Alfred Hospital, Commercial Road, Prahran, Victoria 3181, Australia. h.cheema@alfred.org.au
Summary
Hemichorea-hemiballismus, a rare complication of nonketotic hyperglycemia in type 2 diabetes, can cause involuntary movements. This case highlights symptom improvement with blood glucose control.
Area of Science:
- Neurology
- Endocrinology
- Radiology
Background:
- Hemichorea-hemiballismus is a rare neurological complication linked to nonketotic hyperglycemia, particularly in type 2 diabetes mellitus.
- This condition typically presents with involuntary, jerky movements and is associated with characteristic radiological findings in the basal ganglia.
Observation:
- A case study of a 91-year-old woman with type 2 diabetes experiencing nonketotic hyperglycemia and right-sided hemichorea is presented.
- Initial brain CT revealed hyperdensity in the left lentiform nucleus, with subsequent MRI showing T1 hyperintensity and enlargement of the same area.
Findings:
- The patient's hemichorea symptoms resolved following effective management and control of blood glucose levels.
- Radiological abnormalities, specifically T1 hyperintensity in the lentiform nucleus, were observed contralateral to the motor symptoms.
Implications:
- This case reinforces the association between hyperglycemia-induced metabolic derangements in the basal ganglia and hemichorea-hemiballismus.
- Understanding the pathophysiology, potentially involving impaired cerebral blood flow autoregulation, is crucial for managing this rare diabetic complication.
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