Encephalopathy, Hypoglycemia, and Flailing Extremities: A Case of Bilateral Chorea–Ballism Associated with Diabetic Ketoacidosis
Waldo R. Guerrero; Michael S. Okun; Nikolaus R. McFarland
- Encephalopathy, Hypoglycemia, and Flailing Extremities: A Case of Bilateral Chorea–Ballism Associated with Diabetic Ketoacidosis
Guerrero, Waldo R.
Okun, Michael S.
McFarland, Nikolaus R.
- Center for Parkinson's Disease and Other Movement Disorders
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- Tremor and Other Hyperkinetic Movements
- Background: Hypo/hyperglycemia is a known cause of chorea and hemiballism. The temporallobes, hippocampus, basal ganglia, and substantia nigra are most susceptible to hypoglycemic changes. Methods: We present a caseof bilateral chorea and bi-ballism accompanied by encephalopathyin the setting of severe hypoglycemia and diabetic ketoacidosis. The patient had brain MRI changes involving both caudate nuclei, temporal lobes, and hippocampi. Discussion: This case demonstrates the basal ganglia's vulnerability to hypoglycemia and the need for cautious evaluation of involuntary movements when they occur in the setting of encephalopathy.
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