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Level I Hyperglycemia Alert: A Case Report
Michelle Nassal1, Christopher San Miguel1
1The Ohio State University, Wexner Medical Center, Department of Emergency Medicine, Columbus, Ohio.
Insights
Nonketotic hyperglycemia-associated chorea can mimic stroke, leading to misdiagnosis. Early recognition and treatment of high blood sugar can reverse these neurological symptoms.
Area of Science:
- Neurology
- Endocrinology
Background:
- Nonketotic hyperglycemia-associated chorea is a rare neurological disorder.
- It can be misdiagnosed as seizure or stroke in emergency departments.
- Prompt recognition and treatment can reverse symptoms and avoid harmful interventions.
Purpose of the Study:
- To highlight the diagnostic challenges of nonketotic hyperglycemia-associated chorea.
- To emphasize the importance of recognizing key clinical and imaging features.
- To guide emergency physicians in appropriate management.
Main Methods:
- Case report presentation.
- Discussion of diagnostic pitfalls.
- Review of imaging findings (head CT).
Main Results:
- A case where nonketotic hyperglycemia-associated chorea was initially misidentified as a hemorrhagic stroke due to false-positive CT interpretation.
- Demonstration of how hyperglycemia can mimic stroke presentations.
Conclusions:
- Nonketotic hyperglycemia can present with symptoms and imaging findings similar to stroke.
- Prompt identification of hyperglycemia is crucial for accurate diagnosis and effective treatment.
- Appropriate management of hyperglycemia leads to symptom reversal.
Introduction:
Nonketotic hyperglycemia-associated chorea is a rare condition that upon presentation to the emergency department can be easily misdiagnosed as a seizure or a stroke. Although uncommon, identification of this condition can aid emergency physicians in avoiding unnecessary and potentially harmful treatments for other neurological pathology. Furthermore, prompt hyperglycemic control can result in reversal of symptoms within days.
Case Report:
We present a case of nonketotic hyperglycemia-associated chorea where the patient was transferred to our facility as a hemorrhagic stroke alert, based on a false-positive interpretation of head computed tomography (CT) imaging.
Conclusion:
Nonketotic hyperglycemia on CT imaging and clinical presentation can mimic stroke presentations. Prompt recognition of key features can lead to appropriate treatment.
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