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Published on: November 15, 2024
Hemiballism due to hyperglycemic hyperosmolar syndrome
Elena García Fernández1, Miguel Goñi Imizcoz, María Pilar Alvarez Baños
1Sección de Endocrinología y Nutrición. Complejo Hospitalario de Burgos. Burgos. España.
Summary
Non-ketotic hyperglycemia can cause neurological issues. In this case, Hyperglycemic Hyperosmolar Syndrome (HHS) led to hemichorea-hemiballism in an elderly patient due to a putaminal lesion.
Area of Science:
- Neurology
- Endocrinology
- Geriatrics
Background:
- Non-ketotic hyperglycemia is linked to neurological deficits.
- Hyperglycemic hyperosmolar syndrome (HHS) is a known cause of hemiballism-hemichorea.
- These movement disorders typically result from contralateral putaminal lesions.
Purpose of the Study:
- To report a case of hemichorea-hemiballism syndrome.
- To highlight the association between Hyperglycemic Hyperosmolar Syndrome (HHS) and this specific neurological presentation.
- To underscore the importance of considering metabolic disturbances in elderly patients with movement disorders.
Main Methods:
- Case report of a 95-year-old female patient.
- Clinical presentation and neurological examination findings.
- Diagnostic workup including assessment for hyperglycemia and hyperosmolarity.
Main Results:
- The patient presented with hemichorea-hemiballism syndrome.
- The underlying cause was identified as Hyperglycemic Hyperosmolar Syndrome (HHS).
- Imaging revealed a contralateral putaminal lesion consistent with the neurological deficit.
Conclusions:
- Hyperglycemic Hyperosmolar Syndrome (HHS) can manifest as hemichorea-hemiballism.
- Putaminal lesions are the anatomical correlate for this movement disorder in the context of HHS.
- This case emphasizes the need for prompt recognition and management of metabolic derangements in elderly patients presenting with acute neurological symptoms.
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