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Hemichorea Induced by Non-ketotic Hyperglycemia in a Caucasian Woman

Kristina Pham1, Sreenath Meegada2, Tejo Challa2

  • 1Internal Medicine, Texas College of Osteopathic Medicine, Fort Worth, USA.

Cureus
|March 20, 2020
PubMed

Insights

Hyperglycemia can cause chorea, a movement disorder. In this case, high blood sugar in a diabetic patient led to involuntary movements, which resolved with insulin treatment.

Area of Science:

  • Neurology
  • Endocrinology
  • Metabolic Disorders

Background:

  • Chorea is a hyperkinetic movement disorder with diverse etiologies.
  • Hyperglycemia is an uncommon but recognized cause of secondary chorea.

Observation:

  • A 76-year-old female with diabetes presented with a 2-3 week history of gait disturbance, hemichorea, and dysarthria.
  • Laboratory results revealed severe hyperglycemia (glucose 690 mg/dL) and poor glycemic control (HbA1c 14.7%).

Findings:

  • Head CT showed hyperdensity in the basal ganglia, consistent with hyperglycemia-induced movement disorders.
  • Symptomatic improvement occurred rapidly following insulin therapy and glycemic control.

Implications:

  • This case highlights the importance of considering hyperglycemia in the differential diagnosis of new-onset chorea, particularly in diabetic patients.
  • Prompt recognition and management of hyperglycemia are crucial for reversing these neurological deficits.

Keywords:
hemichoreahyperglycemia

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