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Hemichorea/Hemiballism Associated with Hyperglycemia: Report of 20 Cases

Cosentino, Carlos; Torres, Luis; Nunez, Yesenia; Suarez, Rafael; Velez, Miriam; Flores, Martha

Background: Hemichorea/hemiballism associated with nonketotic hyperglycemia is a well-recognized syndrome, but few case series have been reported in the literature.

Case Report: We describe 20 patients with hemichorea/hemiballism associated with hyperglycemia (9 males and 11 females) with mean age of 67.8 years. Ten patients had a previous diagnosis of type 2 diabetes mellitus, and one had type 1 diabetes mellitus. Six of them had documentation of poor diabetic control over at least the last 3 months. Nine patients had new-onset hyperglycemia with a diagnosis of diabetes mellitus made after discharge. Seventeen patients had unilateral chorea/ballism, while three had bilateral chorea/ballism. Eighteen cases had striatal hyperdensities on computed tomography (CT) and/or hyperintense signals on magnetic resonance imaging (MRI). The putamen was affected in all cases, and the caudate nucleus was involved in nine.

Discussion: Hemichorea/hemiballism associated with nonketotic hyperglycemia can be the presenting sign of diabetes mellitus in almost half of cases or can occur after a few months of poor glycemic control in patients with diagnosed diabetes. This case series is one of the largest to date and adds valuable information about clinical and neuroimaging features that are comparable with published data but also emphasize the role of adequate diabetes mellitus control.

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Title
Tremor and Other Hyperkinetic Movements
DOI
https://doi.org/10.7916/D8DN454P

More About This Work

Academic Units
Center for Parkinson's Disease and Other Movement Disorders
Publisher
The Center for Digital Research and Scholarship
Published Here
November 7, 2016