Comparison of Hemichorea-Hemiballism between Acute Stroke and Nonketotic-Hyperglycinemia in the Clinical Scenario: Report of a Rare Diabetic Complication
Diabetes mellitus is the major cause of retinopathy, nephropathy and neuropathy. Hyperglycemia is one of major major advised effect on diabetes mellitus. Hemichorea-hemiballism, a rare manifestation of nonketotic hyperglycemia, characterized by involuntary arrhythmic motions in one side of the body which results from focal lesions in the contralateral basal ganglia. Here, we present a 39-year-old woman with violent involuntary rapid and irregular movements of left limbs three days prior to emergency department. Nonketotic hyperglycemia related hemichorea-hemiballism had been confirmed by biochemistry examination and brain computed tomography (CT). Aggressive glucose control with insulin was administered. Her symptoms got improvement gradually after euglycemia two weeks later.
2. Buruma OJS, Lakke JP. Ballism. In: Vinken PJ, Bruyn GW, Klawans HL, editors. Handbook of Clinical Neurology: Extrapyramidal Disorders. Amsterdam: Elsevier Science Publishers, 1986: 369-80.
3. Hawley JS, Weiner WJ. Hemiballismus: current concepts and review.
Parkinsonism Relat Disord. 2012; 18(2): 125–9.
4. Jaafar J, Rahman RA, Draman N, Yunus NA. Hemiballismus in Uncontrolled Diabetes Mellitus. Korean J Fam Med. 2018; 399(3): 200-3.
5. Kiryluk K, Khan F, Valeri A. Acute chorea and bilateral basal ganglia lesions in a hemodialysis patient. Kidney Int. 2008; 73(9): 1087-91.
6. Patel B, Ladva ZR, Khan U. Hemichorea-hemiballism: a case report. Pract Neurol. 2015; 15(3): 222-3.
7. Özgür A, Esen K, Kaleağası H, Yılmaz A, Kara E. Diabetic striatopathy in a patient with hemiballism. Emerg Radiol. 2015; 22(3): 347-9.
8. Chang X, Hong W, Yu H, Yao Y. Chorea associated with nonketotic hyperglycemia: A case report with atypical imaging changes. Medicine (Baltimore). 2017; 96(45): e8602..
9. Bizet J, Cooper CJ, Quansah R, Rodriguez E, Teleb M, Hernandez GT. Chorea, Hyperglycemia, Basal Ganglia Syndrome (C-H-BG) in an uncontrolled diabetic patient with normal glucose levels on presentation. Am J Case Rep. 2014; 15:143-6.
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