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Hyperglycemic Hemichorea: A Case Report
Joana Lopes1, Eulália Antunes1, Bárbara Oliveira1
1Internal Medicine, Hospital de Braga, Braga, PRT.
Cureus
|June 21, 2023
Summary
Non-ketotic hyperglycemic hemichorea-hemiballismus is a rare movement disorder linked to uncontrolled diabetes. Prompt diagnosis and metabolic control, including insulin therapy, can effectively resolve these involuntary movements.
Area of Science:
- Neurology
- Endocrinology
- Radiology
Background:
- Chorea and ballism are hyperkinetic movement disorders with diverse etiologies.
- Non-ketotic hyperglycemic hemichorea-hemiballismus (NHH) is a rare complication of poorly controlled diabetes mellitus.
- NHH presents with characteristic MRI findings in the basal ganglia.
Observation:
- A 74-year-old woman with type 2 diabetes presented with acute, involuntary movements of her left side.
- Her blood glucose was severely elevated (541 mg/dL) without ketosis, and HbA1c was 14%.
- Brain MRI revealed T1 hyperintensity in the right corpus striatum, consistent with NHH.
Findings:
- The patient's involuntary movements resolved after insulin therapy and haloperidol administration.
- Metabolic optimization was key to the successful treatment of the choreiform movements.
- The case highlights the diagnostic utility of neuroimaging in conjunction with clinical presentation.
Implications:
- Early recognition of NHH is crucial for timely intervention and management.
- Decompensated diabetes can manifest as a neurological emergency, necessitating prompt metabolic control.
- Raising awareness for NHH can improve diagnosis and patient outcomes in diabetic populations.
Keywords:
decompensated diabetesdiabetes mellitus in elderlyhemiballismushemichoreahyperglycemic hemichoreainvoluntary movementsMore Related Videos
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