Index Presentation of Diabetes Mellitus as a Hyperkinetic Movement Disorder: A Thin-veiled Entity Colloquially called...

Often referred to as the diabetes capital of the world, new-wave urbanization and westernization of lifestyle have rendered India vulnerable to the so-called lifestyle diseases, especially diabetes mellitus. Arguably the most characterized of diseases, diabetes somehow still has a few tricks up its sleeve. Diabetic striatopathy (DS), also known as hyperglycemic nonketotic hemichorea/hemiballism, chorea/hemichorea associated with nonketotic hyperglycemia, diabetic hemiballism/hemichorea, or chorea-hyperglycemia-basal ganglia syndrome, is a long-known disease of many names but sparse characterization. With an estimated prevalence of 1 in 100,000 (Ondo, 2011), DS is, in our opinion, greatly underestimated and is often misdiagnosed as intracerebral hemorrhage (ICH), which is a travesty given the excellent prognosis DS carries, even with just the control of blood sugar levels. Here, we describe the case of a 73-year-old male, previously undiagnosed diabetic, who presented with an acute-onset movement disorder, initially thought to have had a stroke, but was later diagnosed as DS. We also discuss in brief the pathophysiology and treatment options.