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Chorea-Ballismus Associated with Hyperglycemia
Elif Kocasoy Orhan1, M Mert Atmaca1, Melek Atmaca2
1İstanbul University İstanbul Faculty of Medicine, Department of Neurology, İstanbul, Turkey.
Noro Psikiyatri Arsivi
|April 1, 2017
Summary
Chorea-ballismus, a rare complication of nonketotic hyperglycemia, can be an initial symptom of type 2 diabetes. Prompt blood glucose regulation is key for symptom improvement in these patients.
Area of Science:
- Neurology
- Endocrinology
- Metabolic Disorders
Background:
- Chorea-ballismus is a rare neurological complication associated with nonketotic hyperglycemia.
- This condition can present as an initial symptom of type 2 diabetes mellitus.
- Understanding the link between hyperglycemia and involuntary movements is crucial for diagnosis.
Observation:
- Two patients presented with involuntary movements (chorea-ballismus) linked to nonketotic hyperglycemia.
- One patient was undiagnosed with diabetes, while the other had a history of prescribed insulin therapy adherence issues.
- Cranial imaging and biochemical tests were performed for both patients.
Findings:
- Symptoms of chorea-ballismus improved within hours in one patient and days in the other.
- The clinical presentation is attributed to hyperglycemia, cerebral ischemia, and gamma-aminobutyric acid (GABA) pathway dysfunction.
- Blood glucose level regulation significantly impacts symptom resolution.
Implications:
- Emergency physicians should consider chorea-ballismus as a potential first sign of type 2 diabetes.
- Early recognition and management of hyperglycemia are vital for treating this neurological complication.
- This highlights the importance of comprehensive metabolic evaluation in patients with unexplained movement disorders.