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"Dancing belly" in an old diabetic lady.
Souvik Dubey1, Subhankar Chatterjee2, Debaleena Mukherjee1
1Department of Neuromedicine, Bangur Institute of Neurosciences, Institute of Post Graduate Medical Education and Research and SSKM Hospital, Kolkata, West Bengal, India.
Journal of Family Medicine and Primary Care
|August 6, 2020
Summary
This case report highlights a rare instance of multiple movement disorders, including diaphragmatic myoclonus, as the first sign of undiagnosed diabetes. Prompt blood glucose testing is crucial for diagnosing and treating this reversible condition.
Area of Science:
- Neurology
- Endocrinology
Background:
- Movement disorders can be an early indicator of hyperglycemia, a state of elevated blood glucose.
- While chorea-ballism is known in diabetes, monoballism and diaphragmatic myoclonus are exceptionally rare presentations.
Observation:
- A 62-year-old woman, previously unaware of her diabetes, presented with sudden-onset monoballism, focal myoclonus, action myoclonus, and diaphragmatic myoclonus.
- These diverse movement abnormalities resolved completely upon achieving normal blood glucose levels.
Findings:
- This case represents the first reported instance of diaphragmatic myoclonus as an initial manifestation of hyperglycemia.
- The constellation of movement disorders, including rare forms like monoballism and diaphragmatic myoclonus, responded dramatically to glycemic control.
Implications:
- Emphasizes the critical need for immediate capillary blood glucose measurement in patients presenting with acute abnormal movements.
- Highlights how rapid glucose testing can lead to swift diagnosis of a potentially catastrophic but reversible hyperglycemic state, averting extensive and costly investigations.
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