Background: Chorea can be caused by a variety of diseases, including neurodegenerative disorders, vascular events, toxic-metabolic states, and immunologic and infectious diseases. We describe a patient who presented with hemichorea as the initial manifestation of Diabetes Mellitus (DM) and responded partially to the glycemic control.
Case Report: A 63-year-old, healthy Hispanic man with no prior history of medical illness presented with subacute onset, gradually progressive hemichorea of 6 weeks' duration. On evaluation, he was found to have non-ketotic hyperglycemia with high serum glucose (328 mg/dL), elevated hemoglobin A1C (9.9%), and absent ketones. Magnetic Resonance Imaging of the brain demonstrated hyper intense signals in bilateral basal ganglia on T1W images. He was diagnosed to have DM. Despite optimal glycemic control with insulin, the patient continued to have hemichorea at 3 months follow-up and required haloperidol for control of the involuntary movements.
Significance: Involuntary movements, particularly hemichorea, can be a manifestation and rarely be a presenting sign of DM.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4558280 | PMC |
| http://dx.doi.org/10.3402/jchimp.v5.27825 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Anesthetic management using desflurane and nitrous oxide in a child with non-ketotic hyperglycinemia: a case report.
JA Clin Rep
December 2024
Department of Anesthesiology, Niigata University Medical and Dental Hospital, 1-754 Asahimachi-Dori, Chuo-Ku, Niigata, 951-8520, Japan.
Background: Non-ketotic hyperglycinemia (NKH) is a rare autosomal recessive disorder caused by defects in the glycine cleavage system, leading to elevated glycine levels in the central nervous system. NKH manifests in various forms, with the neonatal type being the most severe and often associated with high mortality and significant neurological impairment. This case report highlights the successful uses of desflurane and nitrous oxide for anesthetic management in a patient with NKH.
View Article and Find Full Text PDFClinical and neuroimaging characteristics of diabetic striatopathy: a case series report.
Front Endocrinol (Lausanne)
December 2024
Department of Neurology, First Medical Center of Chinese People's Liberation Army (PLA) General Hospital, Beijing, China.
Background: Diabetic striatopathy (DS) is a rare disorder characterized by clinical manifestations of hemichorea, non-ketotic hyperglycemia, and high signal on T1-weighted MRI or high density on CT scan in basal ganglia, typically associated with poor glycemic control.
Objective: This study aimed to analyze clinical characteristics of patients with diabetic striatopathy to raise awareness amongst physicians, especially endocrinologists, about this rare neurological manifestation in patients with diabetes.
Methods: We retrospectively analyzed the data on clinical presentations, laboratory workups, and cranial CT and MRI of six patients with DS who were admitted to our hospital from October 2013 to June 2022.
Non-ketotic hyperglycaemia-induced hemichorea-hemiballism may represent glioma-like pattern on multimodal magnetic resonance imaging: can H spectroscopy help in the differentiation?
BJR Case Rep
November 2024
Department of Radiology, Zhongshan Hospital Affiliated to Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian 361004, China.
Non-ketotic hyperglycaemia (NKH)-induced hemichorea-hemiballismus (HC-HB) is an infrequent reversible condition observed in individuals with poorly controlled diabetes. In this report, we present a case of NKH-induced HC-HB exhibiting distinctive morphological and functional alterations on conventional magnetic resonance imaging (MRI), diffusion-weighted imaging (DWI), and H magnetic resonance spectroscopy (MRS), followed by subsequent monitoring. A 70-year-old male with a 20-year history of diabetes presented with severe unilateral involuntary movement.
View Article and Find Full Text PDFLatent Autoimmune Diabetes in a Young Female: A Case Report.
Cureus
September 2024
Diabetes and Endocrinology, Peterborough City Hospital, Peterborough, GBR.
Latent autoimmune diabetes (LAD) involves gradual autoimmune destruction of the pancreatic beta cells, leading to reduced insulin production. When it occurs in adults, the term "latent autoimmune diabetes in adults (LADA)" is used, and when it occurs in young people, the term "latent autoimmune diabetes in the young (LADY)" is used. Patients usually present with symptoms suggestive of type 2 diabetes, and test positive for islet cell antibodies, but do not require insulin therapy at diagnosis and for up to six months thereafter.
View Article and Find Full Text PDFUnraveling Diabetic Striatopathy: Clinical and Imaging Perspectives.
Cureus
August 2024
General Medicine, Saveetha Medical College and Hospital, Chennai, IND.
Diabetic striatopathy (DS) is an acute hyperkinetic movement disorder arising from non-ketotic hyperglycemia. This condition predominantly affects females and is more common in the elderly, highlighting the interplay between diabetes, striatal pathology, and neurological movement disorders. DS is characterized by involuntary movements, such as hemichorea or hemiballism, and distinctive neuroimaging findings that can be mistaken for more common cerebrovascular events.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!