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Hemichorea Associated With Nonketotic Hyperglycemia
Xiaoming Chen1, Choudi Ma1, Lijin Zhi1
1Department of Endocrinology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, 524001, China.
The Journal of Clinical Endocrinology and Metabolism
|February 17, 2023
Summary
Hemichorea associated with nonketotic hyperglycemia (HC-NH) is a rare diabetic complication. This study of 16 cases highlights clinical features and suggests hyperglycemia combined with basal ganglia ischemia contributes to HC-NH.
Area of Science:
- Neurology
- Endocrinology
- Radiology
Background:
- Hemichorea associated with nonketotic hyperglycemia (HC-NH) is a rare but significant diabetic complication.
- The underlying pathogenesis of HC-NH remains incompletely understood, leading to potential diagnostic challenges.
Purpose of the Study:
- To elucidate the clinical and neuroimaging characteristics of HC-NH.
- To improve the understanding and reduce misdiagnosis of this rare condition.
Main Methods:
- Retrospective analysis of 16 HC-NH cases diagnosed between 2000 and 2021.
- Review of relevant medical literature to contextualize findings.
- Analysis of clinical data, laboratory results, and neuroimaging (CT/MRI).
Main Results:
- The study included 16 patients (mean age 67.6 years) with hemichorea, predominantly affecting one side.
- Elevated blood glucose (17.51 ± 7.67 mmol/L) and HbA1c (11.9%±3.1%) were noted; 5 patients had new-onset diabetes.
- Neuroimaging revealed basal ganglia abnormalities in 9 cases, and 15 patients showed symptom improvement within 5 days of treatment.
Conclusions:
- This study offers valuable insights into the clinical and neuroimaging features of HC-NH.
- A potential hypothesis suggests that chronic basal ganglia ischemia, exacerbated by hyperglycemia and possibly atherosclerosis, underlies HC-NH.
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