[Hemiballism-Hemichorea Induced by Non-Ketotic Hyperglycemia]

A non-ketotic hyperglycaemia may cause an affection of basalganglia and, in the following, lead to a hemiballism-hemichorea movement-disorder.

A 68-year-old male patient was admitted at our ward with a subacute and painless hemichorea-hemiballism movement-disorder.

Due to elevated levels of glycated haemoglobin, negative ketone bodies in the urine and characteristic changes of the striatum in MR-imaging the diagnosis of a non-ketotic hyperglycemia induced hemichorea-hemiballism was made.

An antidiabetic treatment was applied using Metformin, Insulin glargin and Sitagliptin as well as a symptomatic treatment with Risperidon 3 mg. In the following, blood sugar levels normalized and a beginning regression of symptoms was observed.

The exact pathophysiology of this phenomenon is still not fully understood and will need to be investigated. Nevertheless, this disease should always be taken into consideration if the typical clinical presentation as well as matching laboratory tests and imaging features are found.